重构自发早产作为可预防的不良结果 - - 一个预防工具箱的临床审核
Aparna Ramachandran1,2,3, Darazel Perez4, Adrienne Gordon1,2,4
1Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Acta obstetricia et gynecologica Scandinavica
|February 20, 2025
概括
大多数自发的早产发生在低风险妇女中,目前的工具无法预测. 遵守自发早产 (sPTB) 预测和预防的指导方针是不理想的,强调需要改进策略.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 公共卫生 公共卫生
背景情况:
- 自发早产 (sPTB) 是围产期发病率和死亡率的主要原因.
- 目前的指导方针建议对sPTB进行预测和预防措施.
- 本研究评估了这些指导方针的遵守和有效性.
研究的目的:
- 评估对sPTB预测和预防的临床指南的遵守情况.
- 评估目前sPTB预测工具的有效性.
- 发现sPTB的识别和管理中的差距.
主要方法:
- 在澳大利亚一家医院 (2019-2020) 进行单个自发早产 (<37周) 的回顾性审计.
- 排除终止和胎儿异常的情况.
- 收集关于母亲人口统计,产前护理,预测措施,预防性治疗和结果的数据.
主要成果:
- 分析了267例sPTB病例;78%发生在被归类为低风险的女性中.
- 细菌性尿 (59.1-65.9%) 和宫长度测量 (65-72%) 的查的顺利遵守.
- 很少有sPTB病例 (10.7-11.4%) 在孕期早期被确定为宫短.
结论:
- 遵守sPTB预测和预防指导方针是不理想的.
- 目前的预测工具无法识别大多数患有sPTB的女性,特别是那些没有已知的危险因素的女性.
- 尽管目前的干预措施,sPTB仍然与增加的围产期死亡风险有关.
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