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根据罗布森分类的分娩方式以及受限和小的妊娠年龄胎儿的周产期结果
Jaqueline Brandão Mazzola1, Ana Cristina Perez Zamarian1, Ana Carolina Rabachini Caetano1
1Department of Obstetrics Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
概括
胎儿生长限制 (FGR) 与较高的剖腹产率和较差的结果有关. 然而,阴道分娩对于特定罗布森分类组中的FGR胎儿是可行的,这表明应该考虑它.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 胎儿生长限制 (FGR) 和小于妊娠年龄 (SGA) 的胎儿存在着不同的临床挑战.
- 在这些高风险妊娠中,分娩方式及其对围产期结果的影响需要仔细评估.
研究的目的:
- 评估使用罗布森分类 (RC) 对FGR和SGA胎儿的分娩方式.
- 为了比较FGR,SGA和对照组之间的围产期结果.
主要方法:
- 单独怀孕的回顾性队列研究 (2018-2019).
- 根据德尔菲共识定义的FGR;RC组分为两段时间 (1-5.1和5.2-10).
主要成果:
- 与SGA (n=20) 和对照组 (n=747) 相比,FGR病例 (n=85) 显示出较高的低出生体重 (<1500g),剖腹产 (CS),新生儿复苏和NICU入院率.
- FGR胎儿主要在RC组5.2-10中,而SGA和对照在RC组1-5-1.1中.
- 在RC组1-5.1中没有观察到分娩方式的显著差异,所有组的阴道分娩率都更高.
结论:
- 胎儿生长限制与增加的CS率和不良周产期结果有关.
- 阴道分娩是RC组1-5.1内近60%的FGR胎儿的安全选择,而围产发病率没有显著增加.
- 对于FGR胎儿,尤其是罗布森分类较低的胎儿,应考虑使用阴道途径.
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