在怀孕23周之前产前膜破裂:前性观察性研究
Laura Goodfellow1, Angharad Care1, Ciara Curran2
1Women's and Children's Health, University of Liverpool, Liverpool, UK.
BMJ medicine
|April 11, 2024
概括
在妊娠23周之前产前膜破裂 (PPROM) 对母亲和婴儿都有很高的风险. 只有26%的新生儿存活到医院出院,观察到显著的孕产妇败血症率.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 孕产妇健康 孕产妇健康
背景情况:
- 在妊娠23周之前产前膜破裂 (PPROM) 是一种罕见但关键的产科并发症.
- 有限的数据存在于这样一个早期的妊娠年龄对PPROM的围产和孕产妇结局.
研究的目的:
- 描述23周妊娠前发生的PPROM怀孕的产周和孕产妇结果.
- 为改善咨询和指导方针的发展提供数据,用于这种高风险的产科情景.
主要方法:
- 使用英国产科监测系统 (UKOSS) 进行了一项前性,观察性,全国性队列研究.
- 在2019年9月至2021年2月期间,从194个英国产科单位收集了数据.
- 包括怀孕16+0至22+6周之间患有PPROM的妇女,分析围产生存率和孕产妇发病率.
主要成果:
- 对于单子怀孕,活产率为44% (范围为30-62%),存活到出院为26% (范围为17-53%).
- 严重的新生儿发病率发生在18%的幸存者中 (范围为12-48%).
- 孕产妇的败血症发生在12%的单胎和29%的多胎妊娠中,有两例死亡和三例重症监护入院.
结论:
- 在23周之前对PPROM的预期管理导致新生儿的26%的存活率到医院出院.
- 围产期和孕产妇的高发病率和死亡率强调了这种情况的严重性.
- 孕产妇败血症是一个需要进一步调查的重大风险,目前的指南需要根据这些发现进行更新.
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