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为子宫内胎儿复苏进行常规孕产妇氧气补充的取消实施:一项回顾性队列研究
Sarah E Chisholm1, Mariella Gastanaduy2, Adrem Elmayan2
1Ochsner Clinical School, Ochsner Health, Dartmouth-Hitchcock Pediatric Residency Program, University of Queensland, Herston, Queensland, Australia.
American journal of perinatology
|August 29, 2024
概括
停止为胎儿复苏提供母体氧补充剂并没有增加新生儿酸性病的风险. 这项现实研究支持了针对患有II类痕迹的分娩患者日常使用氧气的指导方针.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 产周研究 产周研究
背景情况:
- 目前的指导方针推母亲的氧气用于II类产妇内追踪.
- 新出现的数据质疑母亲补充氧气对胎儿复苏的好处.
- 这项研究解决了在临床实践中验证退出实施的必要性.
研究的目的:
- 为了验证,停止为胎儿复苏提供母体氧补充剂不会增加新生儿酸性血症的风险.
- 评估停止常规氧气使用对患有II类痕迹的分娩患者的现实影响.
- 提供支持最新临床实践指南的证据.
主要方法:
- 在一个单一的第三级护理中心进行了回顾性观察性研究 (2019年1月 - 2021年6月).
- 包括单独/双胞胎怀孕 (23-42周) 与持续的II类追踪,不包括主要的胎儿异常或母亲的禁忌.
- 将历史的对照组与脱产后的队列进行了比较,分析了新生儿酸血症 (带pH值<7.2) 和次要结局.
主要成果:
- 在新生儿酸血症 (13.8%与15.4%) 中没有显著的差异. 后撤销和历史对照组之间.
- 新生儿酸性血症的调整后几率比为0.87 (95% CI:0.62,1.22).
- 严重的酸血症,低的阿帕格分数和NICU入院患者在撤销后并没有增加.
结论:
- 停止为胎儿复苏提供常规的母体氧补充剂是安全的,并且不会增加新生儿酸血症.
- 现实世界的数据证实了有关分娩期间母亲氧化量的实验发现.
- 这支持了指导方针,建议在II类追踪中不使用常规的母体氧气.
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