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引发分娩的持续时间对于第二季度的药物治疗堕胎和不良结果
Ashish Premkumar1, Vanya Manthena, Jocelyn Wascher
1Pritzker School of Medicine and the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Rush University School of Medicine, and Feinberg School of Medicine, Northwestern University, Chicago, and NorthShore University HealthSystem, Evanston, Illinois; and Washington University School of Medicine in St. Louis, St. Louis, Missouri.
在第二个三个月的药物堕胎中,分娩时间较长与增加的母亲不良结果有关,特别是临床胆膜炎. 这一发现凸显了监测分娩时间对于患者安全的重要性.
科学领域:
- 生殖健康 生殖健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药理干预药理干预
背景情况:
- 第二个三个月的药物流产是一种常见的程序.
- 了解影响不良结果的因素对于患者安全至关重要.
- 劳动时间是堕胎过程中的关键变量.
研究的目的:
- 调查分娩持续时间和第二个三个月的药物堕胎中母亲不良结果之间的关联.
- 为了确定与延长劳动有关的特定不良结果.
- 探索潜在的修改因素,如妊娠年龄,子宫痕和平价.
主要方法:
- 在四个中心进行回顾性队列研究.
- 包括在没有先前存在的并发症的情况下接受第二季度药物流产的个人.
- 主要暴露:分娩时间 (美索普罗斯托尔到驱逐).
- 主要结局:复合发病率 (子宫破裂,输血,胸膜炎,ICU入院,再入院).
- 统计分析包括双变量和多变量负二项式回归.
- 针对妊娠年龄,子宫痕和子宫平价的子组分析.
主要成果:
- 包括681个人;中位数的劳动时间为11小时.
- 19.2%的人患有复合发病率.
- 较长的分娩时间 (连续和分类) 与增加的发病风险有显著的关联.
- 在较长的劳动持续时间 (26.2%对10.6%) 中,临床膜炎显着更高.
- 妊娠年龄,子宫痕和子宫平价并没有显著改变复合发病率的风险.
结论:
- 劳动的持续时间是一个独立的风险因素,对第二个三个月的药物堕胎中不良的母亲的结果.
- 临床膜炎是与长期分娩相关的关键不良结果.
- 研究结果强调需要对分娩时间进行警监测,以减轻风险.
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