经阴道分娩的妇女与周围门克罗恩病:为什么不?
Irene J Schaafsma1,2, Froukje J Hoogenboom2, Gerard Dijkstra1
1Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (Drs Schaafsma, Dijkstra and Visschedijk).
AJOG global reports
|April 24, 2024
概括
目前的指导方针建议剖腹产是对患有周克罗恩病的孕妇. 然而,这项研究发现,在克罗恩病妇女的阴道分娩后,便失禁或近部疾病进展没有显著增加.
科学领域:
- 胃肠病学 胃肠病学
- 产科 产科 产科 产科 产科
- 临床医学 临床医学
背景情况:
- 目前欧洲克罗恩氏炎和结肠炎组织的指导方针建议在患有活跃周克罗恩氏病的孕妇进行剖腹产.
- 这一建议是基于假设,阴道分娩加剧周围门疾病和恶化便节.
- 然而,缺乏支持这一假设的强有力的证据.
研究的目的:
- 调查分娩方式对围部疾病进展和围部克罗恩病妇女便失禁的影响.
- 评估当前对患有活跃周克罗恩病的孕妇的产科建议.
主要方法:
- 对102名患有围性克罗恩病的妇女进行了回顾性队列研究,她们已经分娩了.
- 通过问卷收集的数据,包括便节的Vaizey分数.
- 统计分析包括描述性和线性回归分析.
主要成果:
- 在阴道分娩和剖腹产分娩组之间,没有观察到便失禁或近部疾病进展的显著差异.
- 剖腹产的中位数为5,阴道分娩的中位数为7.
- 18.8%的阴道分娩组和22.2%的剖腹产组报告了周围疾病的进展.
结论:
- 阴道分娩不会显著增加便失禁或周围门疾病进展的风险,在妇女有活跃的周围门克罗恩病.
- 这些发现挑战了当前的指导方针,并表明需要更多个性化的产科咨询.
- 这项研究支持对这种患者群体的输送建议进行重新评估.
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