查和预防早产:在临床实践中是如何进行的?
Roberta Bulsing Dos Santos1,2, Janete Vettorazzi1,2,3, Marcos Wengrover Rosa2
1Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
概括
私人诊所的产科医生比公共诊所的产科医生更有可能使用通用超声波查早产. 阴道孕激素对于宫短是常见的,但需要正式的查协议.
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:
- 过早分娩仍然是全球新生儿死亡率和发病率的主要原因.
- 有效的查和预防策略对于改善妊娠结果至关重要.
- 了解中等收入国家的当前临床实践对于有针对性的干预措施至关重要.
研究的目的:
- 评估和比较在中等收入国家的公共与私人医疗保健机构的产科医生之间的早产查实践.
- 确定超声波用于宫长度测量和其他早产查方法的当前趋势.
- 评估阴道孕激素处方在预防早产的短宫的流行情况.
主要方法:
- 进行了一项横截面研究,涉及265名妇产科医生.
- 通过在线问卷收集数据,评估早产儿查和预防实践.
- 受访者根据他们的实践环境进行分类:公共或私人设施.
主要成果:
- 通过超声波测量宫长度进行的普遍查在公共实践中被执行的比例为11.3%,而私人实践中为60.7% (p < 0.001).
- 在公共实践中,对于异常的手动检查,有43%的人要求通过阴道进行超声波检查,74.6%的人要求高风险怀孕.
- 阴道孕激素治疗短宫的处方是所有受访者的90.6%.
结论:
- 在这个中等收入环境中,公共部门和私营部门之间存在普遍的早产查实践的显著差异.
- 虽然用于短宫的孕激素使用率很高,但普遍的超声波查未得到充分利用,特别是在公共设施中.
- 显然需要在中等收入国家制定标准化的早产查和预防方案,以减少新生儿不良后果.
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