对于22-25周怀孕的分娩产科管理的考虑
Felicia V LeMoine1, Ashley N Battarbee2, Colm P Travers3
1Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston, Houston, US. felicia.v.lemoine@uth.tmc.edu.
概括
优化对极度早产婴儿 (22-23周) 的护理至关重要. 虽然干预措施有利于以后的早产,但对于最早的怀孕需要更多的研究.
科学领域:
- 新生儿医学 新生儿医学
- 周围生理学 周围生理学
- 公共卫生 公共卫生
背景情况:
- 极度早产 (22-25 5/7周) 占美国婴儿死亡率的很大一部分.
- 已建立的干预措施改善了24周及以后的出生结果.
研究的目的:
- 审查目前关于极度早产的产前和产后干预措施的证据.
- 突出需要进一步的研究,以优化在22-23周怀孕时分娩的护理.
主要方法:
- 对产前和产后干预措施的观察数据的审查.
- 对非常早产婴儿的结果现有文献的分析.
- 讨论在临床护理中共享决策原则.
主要成果:
- 诸如产前皮质类固醇和硫酸之类的干预措施对于24周及以上的分娩是有效的.
- 观察数据表明22-23周出生可能有好处,但有限.
- 目前的数据受到小样本规模和管理不一致的阻碍.
结论:
- 涉及家庭和多学科团队的共同决策对于最佳护理至关重要.
- 需要进一步的研究来评估目前在22-23周出生时的干预措施的有效性.
- 需要改进的研究,以提高生存率和降低早期早产儿的死亡率.
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