胎盘分级对怀孕结果的影响:回顾性队列研究
Antonios Siargkas1, Ioannis Tsakiridis1, Georgios Michos1
1Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Healthcare (Basel, Switzerland)
|March 28, 2025
概括
早产胎盘化 (PPC) 与不良的围产期结局有关,例如对于妊娠年龄的小 (SGA) 和胎儿生长限制 (FGR). 在怀孕期间分级胎盘化可以改善风险评估和临床决策.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 诊断性超声波 超声波 超声波 超声波
背景情况:
- 胎盘分级是胎盘成熟度的一种衡量方法,在临床上未得到充分利用.
- 早产胎盘化 (PPC) 可能对怀孕结果的预后影响.
研究的目的:
- 调查早产胎盘化 (PPC) 和围产期结局之间的关联.
- 在一个大队伍中评估胎盘分级的预后价值.
主要方法:
- 对3088个单独怀孕的回顾性队列研究.
- 使用格兰纳姆系统 (等级0-3),对胎盘化的第三个三个月的超声波评估.
- 主要结局的分析:对于妊娠年龄 (SGA) 和妊娠前来说很小;次要结局:胎儿生长限制 (FGR),妊娠高血压,死胎,出生时的妊娠年龄和出生体重百分之一.
- 针对孕产妇和胎儿混因素进行调整的分析.
主要成果:
- 17.6%的人患有2级,1.3%的人患有3级的胎盘化.
- 2级PPC与SGA (aOR 1.80) 和FGR (aOR 1.81) 的几率增加有关.
- 3级PPC显示SGA (aOR3.09) 和FGR (aOR3.26) 的几率更高.
- PPC与较低的出生体重百分位数和出生时较早的妊娠年龄有关.
- 没有发现与妊娠前或死产有显著的关联.
结论:
- 早期的胎盘化,特别是3级,与包括SGA和FGR在内的不良围产期结局有显著联系.
- 将胎盘分级纳入常规产前护理可以提高风险分层.
- 胎盘分级提供了超越传统方法的有价值的临床决策见解.
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