产前德克萨米他用于晚期早产:完整疗程率和新生儿结局
Piyamon Srisakulpanich1, Pattarawalai Talungchit1, Tachjaree Panchalee1
1Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
概括
在晚期早产中,仅在三分之一的病例中,达到了完全的德克萨米他给药. 然而,完整的疗程改善了单子的呼吸结果,减少了双胞胎的败血症,尽管总体死亡率和严重发病率相似.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 晚期早产 (34-36周) 是常见的,并与新生儿并发症有关.
- 产前皮质类固醇治疗,像德克萨米他,用于成熟胎儿的肺.
- 在这个人群中,完成德克萨米他疗程的速率和影响需要进一步研究.
研究的目的:
- 为了确定在晚期早产中完全施用德克萨梅他的速度.
- 评估完整的德克萨米他疗程与单胎儿和双胞胎新生儿结局之间的关联.
主要方法:
- 从2018年到2020年,对1500例晚期早产 (34-36+6周) 的回顾性队列研究.
- 对德克萨米他的医疗记录进行分析 (完整,不完整,没有).
- 新生儿结局的比较 (阿巴格分数,呼吸暂停,败血症,死亡,严重发病率) 之间的群体,分层由单个和双胞胎怀孕.
主要成果:
- 德克萨米他的完整疗程率为31.7% (29.2%单身,48.4%双胞胎).
- 单体新生儿服用完整的甲基的几率较低,Apgar <7和呼吸暂停.
- 双胞胎新生儿服用完整的甲的发生率显著降低新生儿败血症.
结论:
- 不到一半的晚期早产妊娠接受了完整的德克萨米他疗程.
- 完整的甲改善了特定的新生儿结局 (单胎儿的呼吸系统,双胞胎的败血症),但没有显著影响整体死亡率或严重发病率.
- 结果表明,在晚期早产中,完全产前德克萨米他的潜在益处很大,但由于样本大小和置信区间,需要谨慎解释.
相关概念视频
Drug Dosing: Infants and Children
257
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
257
Pathophysiology of Diabetes
3.2K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
3.2K
Local Anesthetics: Clinical Application as Epidural Anesthesia
687
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
687
Pharmacokinetics in Pediatric Patients: Drug Excretion
214
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
214
Diabetes Mellitus: Type 2 and Gestational
4.4K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.4K
Teratogenicity
4.0K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
4.0K


