出血风险评分和周周部分的量化血液损失
Rubinnis Gutierrez-Disla1, Rachana Gheewala1, Joshua Fogel1,2
1Department of Obstetrics and Gynecology, NYC/H+H - South Brooklyn Health, Brooklyn, New York, USA.
Proceedings (Baylor University. Medical Center)
|December 23, 2024
概括
妇女健康,产科和新生儿护士协会 (AWOHNN) 的风险评分显示,阴道分娩中量化血流 (QBL) 的增加与显著相关. 建议对AWOHNN工具进行修订,以改善风险分层和身体质量指数 (BMI) 整合.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 临床风险评估临床风险评估
背景情况:
- 临床医生使用风险评估工具来识别有过度出血风险的患者.
- 这项研究研究了围产部出血风险评分和阴道分娩的量化血液损失 (QBL) 之间的关联.
- 重点是患者通常被认为较低风险的周周出血.
研究的目的:
- 评估妇女健康,产科和新生儿护士协会 (AWOHNN) 风险评估工具在预测产后出血方面的有效性.
- 为了检查AWOHNN风险得分和量化流血 (QBL) 之间的关联,在患者的阴道分娩.
- 在AWOHNN风险分层框架内评估身体质量指数 (BMI) 和QBL之间的关系.
主要方法:
- 对1221名经过阴道分娩的患者进行了回顾性分析.
- 使用AWOHNN风险评估工具将患者分为低,中,高风险组.
- 结果变量包括QBL,QBL≥500毫升的发生率,以及分娩后与分娩前血红素的比率.
主要成果:
- 高风险的AWOHNN得分与QBL增加有显著的关联 (P=0.04),而中等风险的得分则没有.
- 持续的BMI与增加的QBL显著相关 (P=0.049),但分类的BMI (使用AWOHNN截止值>35) 却没有.
- AWOHNN评分与QBL≥500毫升或血红素比率没有显著相关.
结论:
- 目前的AWOHNN风险评估措施可能需要修订,以更准确地反映中等风险患者.
- 应考虑采用其他方法将BMI纳入AWOHNN风险评分.
- 需要进一步的研究,以优化在阴道分娩中产后出血的风险预测.
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