胎盘增殖谱的分娩时间:晚些时候是可行的
Elise A Rosenthal1, Alesha White2, Ashlyn K Lafferty2
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
American journal of obstetrics and gynecology
|February 21, 2025
概括
在怀疑有胎盘增殖谱的怀孕中,延迟分娩,没有其他并发症,可以改善新生儿的结果. 迟到的分娩不会对在专业中心的母亲的结果产生负面影响.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科 产科 产科 产科 产科
- 围产期护理 围产期护理
背景情况:
- 目前的推建议在34 0/7和35 6/7周之间进行分娩,因为怀疑有胎盘增殖谱 (PAS).
- 支持这些妊娠年龄建议的证据有限.
- 第三级护理中心可以管理无并发性PAS怀孕,并计划分娩后期,在36 0/7和37 6/7周之间.
研究的目的:
- 评估延迟分娩对怀孕怀疑有胎盘增殖谱的孕妇和胎儿结果的影响.
- 为了比较产前和产后的分娩结果,怀孕36 0/7周.
主要方法:
- 从2009年8月到2022年4月怀疑PAS的怀孕 (≥24 0/7周) 的回顾性研究.
- 基于分娩时间的母亲和新生儿结局的比较:在36 0/7周之前与之后.
- 使用千平方和学生t测试进行统计分析.
主要成果:
- 在202名患者中,65人 (32%) 表示过早分娩,而137人 (68%) 计划在36 0/7周后分娩.
- 中位分娩妊娠年龄为35周 (指示) 和37周 (计划).
- 指定的早产与增加全血输血和减少血小板输血有关. 新生儿结局 (出生体重降低,新生儿集中治疗室入院,呼吸困难,通风,长时间停留) 更糟糕,可能是由于早产.
结论:
- 在36 0/7周后的计划分娩对于在专业中心的无并发怀疑PAS怀孕中对母亲的结果是安全的.
- 在晚期早产/早产期中延迟分娩改善了新生儿的结果.
- 没有出血或孕前等症状的患者可以在晚些时候安全地分娩.
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