在有严重特征的妊娠前兆中保守管理的怀孕结果
Anuchit Inta1, Theera Tongsong1, Kasemsri Srisupundit1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Journal of clinical medicine
|October 14, 2023
概括
具有严重特征的孕前的保守管理在65%的病例中实现了妊娠延长. 高尿蛋白/肌素比率独立预测更短的延长,尽管母亲和胎儿的结果仍然相似.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 在怀孕期间关键护理.
背景情况:
- 患有严重特征的孕前对母亲和胎儿都有重大风险.
- 保守 (预期) 管理旨在延长怀孕,允许胎儿成熟,但其有效性和安全性需要仔细评估.
- 了解影响保守管理持续时间的因素对于优化临床决策至关重要.
研究的目的:
- 为了评估怀孕后果在妇女怀孕前与严重的特征进行保守管理.
- 在保守的管理下,确定与成功延长妊娠 (≥48小时) 相关的因素.
- 为了比较不同妊娠延长时间的群体之间的孕产妇和胎儿结果.
主要方法:
- 一项回顾性研究,对100名怀孕的孕前,重症特征 (妊娠年龄23-34周) 进行了保守管理.
- 患者被分为两组:妊娠时间延长≥48小时和<48小时.
- 多变量分析和卡普兰-梅尔生存分析被用来评估影响延长的因素,并比较结果,重点是尿蛋白/肌素比率 (UPCI).
主要成果:
- 65%的怀孕延长了至少48小时,平均延长时间为2.9天.
- 入院时尿中蛋白质/肌素比例高 (UPCI) 与延长时间小于48小时 (OR 0.86,p=0.04) 有显著的关联.
- 孕产妇和胎儿的结果,包括剖腹产率,出生体重和分娩时的妊娠年龄,在两组之间没有显著差异.
结论:
- 保守的管理可以成功地延长怀孕,在65%的病例中,孕前有严重特征.
- 高入院UPCI是一种独立的预测器,可以预测怀孕延长时间较短 (<48小时) 和保守的治疗.
- 尽管延长时间不同,但保守的管理没有显示出母亲或胎儿发病率的显著差异,因此需要进一步调查其益处和风险.
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