药理性静脉血栓塞栓症 预防早产前期 产前期 膜破裂
Danielle L Chirumbole1, Manisha Gandhi1, Steven L Clark1
1Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX.
American journal of obstetrics & gynecology MFM
|May 31, 2024
概括
四分之一的早产前膜破裂 (PPROM) 的孕妇在常规静脉血栓栓塞 (VTE) 预防后12小时内意外分娩,存在风险. 仔细考虑VTE预防风险和益处对于长时间PPROM住院至关重要.
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
- 血栓形成研究研究
背景情况:
- 由于早产前膜破裂 (PPROM) 而长时间住院,往往会引发静脉血栓塞栓症 (VTE) 预防建议.
- 在PPROM患者中,与VTE预防药物治疗相比,意外分娩的时间尚未确定.
研究的目的:
- 确定PPROM患者在标准药理VTE预防剂量的12小时内意外分娩的比例.
- 评估常规VTE预防对PPROM患者的潜在影响.
主要方法:
- 追溯队列研究分析了2011年1月至2020年9月的数据.
- 包括接受PPROM预期管理的患者,重点关注72小时后未分娩的患者.
- 分析了与每天服用埃诺沙巴林和区域麻醉指南相关的意外分娩时间.
主要成果:
- 在139个符合条件的PPROM病例中,43% (60名患者) 发生了意外分娩.
- 在所有包含的PPROM病例中,24% (33名患者) 在典型的埃诺沙巴林剂量后12小时内分娩.
- 这种时间恰逢区域麻醉可能适得其反的时期.
结论:
- 很大一部分PPROM患者在潜在的VTE预防药物注射后不久就会面临意外分娩.
- 常规的药理学VTE预防可能会带来风险,包括麻醉并发症和出血.
- 关于药理与机械VTE预防的个性化风险益处讨论对于长期PPROM入院至关重要.
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