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在产期时患有III类肥胖症的无产妇:诱导分娩或没有分娩的剖腹产
Yossi Bart1, Rachel L Wiley1, Ipsita Ghose1
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School at UTHealth Houston, Houston, Texas.
American journal of perinatology
|September 2, 2024
概括
对于接受劳动诱导的肥胖无孕个体,诱导分娩和没有分娩的剖腹产分娩之间没有差异. 诱导后指示剖腹产的发生率很高.
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
- 在怀孕期间的肥胖症
背景情况:
- 无卵性个体的III类肥胖 (BMI ≥40 kg/m2) 与产科风险增加有关.
- 在肥胖的人群中,剖腹产 (CD) 率更高.
- 对于这个高风险群体来说,最佳的交付管理需要仔细考虑.
研究的目的:
- 为了比较产妇和新生儿之间的产业诱导和剖腹产 (CD) 没有劳动在 nulliparous个体与III类肥胖之间的产妇和新生儿结果.
- 为了评估BMI≥50kg/m2的子组的结果.
- 为了比较没有分娩的CD和诱导后的指示CD之间的结果.
主要方法:
- 从2020年3月到2022年2月,对无卵性单子分娩 (≥37周,BMI ≥40 kg/m2) 的回顾性队列研究.
- 排除标准:自发分娩,胎儿形,死产.
- 主要结局:综合产妇死亡率/发病率;次要结局:综合新生儿发病率. 用多变量逻辑回归进行分析.
主要成果:
- 在8,623次分娩中,308次 (4%) 符合标准;250次 (81%) 诱导,58次 (19%) 没有劳动力的CD.
- 没有分娩的CD的指示包括表现不当 (45%) 和疑似宏观性 (14%).
- 综合性孕产妇发病率 (aOR=2.14) 和新生儿发病率 (aOR=3.62) 在没有分娩的CD和分娩诱导组之间没有差异.
结论:
- 在患有III类肥胖症的无产期患者中,超过50%接受诱导的患者有CD.
- 短期孕产妇和新生儿病率在产业诱导和CD没有劳动之间是相似的.
- 在没有分娩的CD和在分娩诱导后指示的CD之间,结果也相似.
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