保守地管理胎盘增长频谱和母乳生产
Jennie Coselli1, Elias Kassir, Katherine Lambert
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas.
Obstetrics and gynecology
|August 22, 2024
概括
与子宫切除相比,对胎盘增殖谱 (PAS) 的保守管理可能会延迟哺乳期的开始. 在PAS中保留的胎盘与更高的产后孕激素水平有关,这可能会影响母乳养.
科学领域:
- 产科和妇科 产科和妇科
- 生殖内分泌学 生殖内分泌学
- 哺乳期生理学 哺乳期生理学
背景情况:
- 胎盘积分谱 (PAS) 的保守管理涉及胎儿分娩与胎盘在位保留.
- 关于在PAS中保留的胎盘对哺乳机构的影响的数据有限.
- 了解哺乳动态对于产后母亲护理至关重要.
研究的目的:
- 评估PAS患者的母乳产量,特别是第二阶段乳腺发育开始的时间.
- 为了比较保守管理 (胎盘保留) 和子宫切除组之间的哺乳期开始和激素水平.
- 评估被保留的胎盘对乳房相关的产后荷尔蒙环境的影响.
主要方法:
- 对126名被诊断患有PAS的患者进行前性队列研究.
- 收集了关于母乳养的临床数据和β-hCG和孕激素的实验室值.
- 在保留胎盘和子宫切除组之间比较第二阶段乳腺生成和激素水平的发病时间.
主要成果:
- 在保守的管理下,到第二阶段乳腺生成的平均时间为5.6天,而剖腹产切除术的平均时间为3.8天 (P =.07).
- 两组之间没有观察到β-hCG水平的显著差异.
- 产后孕激素水平在保留胎盘的组 (62.9 ng/mL) 与切除子宫的组 (1.86 ng/mL) 相比显著更高 (P <.001).
结论:
- 与子宫切除相比,PAS的保守管理可能与乳腺发育延迟的趋势有关.
- 在PAS中保留的胎盘与明显更高的产后孕激素水平有关.
- 需要进一步的研究来阐明这些发现对PAS患者的哺乳期的确切机制和临床影响.
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