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在患有病态肥胖妇女的分娩时间和方式方面的挑战
Nivedita R Aedla1, Tahir Mahmood2, Badreldeen Ahmed3
1Simpsons Centre for Reproductive Medicine Royal Infirmary of Edinburgh, Edinburgh, UK.
Best practice & research. Clinical obstetrics & gynaecology
|December 27, 2023
概括
肥胖的孕妇面临更高的风险,包括死产,特别是严重肥胖的孕妇. 在40周之前计划分娩可能会降低II和III类肥胖的风险,平衡母亲和胎儿的结果.
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
- 公共卫生 公共卫生
背景情况:
- 全球肥胖率上升,特别是在生育年龄的妇女中.
- 肥胖是妊娠并发症的独立风险因素,如糖尿病,高血压和巨.
- 在肥胖的孕妇中增加死产和产后并发症的风险.
研究的目的:
- 审查有关肥胖孕妇分娩时间和方式的证据.
- 为优化母亲和胎儿的结果提供建议.
- 为了解决何时以及如何在肥胖怀孕中分娩的困境.
主要方法:
- 对现有文献和指导方针的审查 (NICE,RCOG,ACOG,WHO).
- 对肥胖和怀孕结果的观察性研究的分析.
- 检查与不同类型的肥胖相关的风险 (I,II,III).
主要成果:
- 死产的风险随体重增加而增加,在42周以后的III类肥胖症中急剧增加.
- 在34周以后的肥胖女性中,死产的风险明显更高.
- 对于II类和III类肥胖症,在40周前计划的诱导或剖腹产可能会降低围产死亡率,尽管可能会增加孕产妇的发病率.
结论:
- 在40周前计划分娩是有利于II类和III类肥胖症,以减少围产死亡率.
- 对于I类肥胖症,结果与正常体重的妇女在分娩时间和方式方面相似.
- 对计划交付的风险和好处进行个性化讨论对于明智的决策至关重要.
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