一个前性研究的乳酸水平在不复杂的自发和诱导劳动
Whitney Kleinmann1,2, Amanda Zofkie1,2, Donald McIntire1,2
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
American journal of perinatology
|April 9, 2024
概括
乳酸水平在不复杂的分娩过程中自然会增加,特别是在推动过程中. 这种上升可能超过正常范围,可能会使孕妇的败血症诊断感到困惑.
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
- 临床化学 临床化学
背景情况:
- 产妇的乳酸水平在分娩期间可以超过非孕妇范围.
- 医院的败血症协议可能会误解劳动引起的乳酸升高.
- 了解正常分娩的乳酸动态对于准确的临床评估至关重要.
研究的目的:
- 观测和量化母乳酸水平在无并发症分娩期间的变化.
- 要区分生理上升的乳酸盐与病理上升.
- 提供用于临床解释劳动患者乳酸水平的数据.
主要方法:
- 在早期分娩 (≥37周妊娠期) 患者的前性研究.
- 乳酸水平在基线,完全扩张和分娩第二阶段 (长达3小时) 每30分钟测量一次.
- 纳入标准:3-4厘米扩张,早期劳动与ROM<12小时,或诱导的oligohydramnios/postdates.
主要成果:
- 观察到乳酸水平在30分钟内显著增加,在完全宫扩张后推动 (p <0.01).
- 在分娩的第二阶段,乳酸的平均变化为2.0±1.8 mmol/L.
- 虽然这种差异在患有膜炎的患者中更为明显,但在统计学上没有显著意义.
结论:
- 乳酸水平在分娩的第二阶段显著上升,特别是在推.
- 劳动患者乳酸水平升高可能是正常的生理反应.
- 这项研究强调了在解释母乳酸水平时考虑分娩阶段的重要性,以避免误诊败血症.
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