肥胖分娩与外周止痛的孕产妇的孕产妇和产周结局:一个系统的审查
Ewout C van der Wal1, Johannes J Duvekot2, Ilse J J Dons-Sinke1
1Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
Journal of perinatal medicine
|July 15, 2025
概括
经过阴道分娩的肥胖孕妇的外周止痛 (EA) 对于孕产妇和围产期的结果没有足够的证据. 需要更多的研究来了解这种人群的具体风险和益处.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 怀孕期间的肥胖在阴道分娩期间带来了增加的风险.
- 准则建议对肥胖的孕妇进行早期的外周止痛 (EA).
- 关于EA对肥胖妇女的孕产妇和产周结果的影响的证据有限.
研究的目的:
- 系统地审查对肥胖妇女阴道分娩期间外周止痛 (EA) 相关的孕产妇和产周结局的现有文献.
- 评估证据的质量,并确定有关EA在肥胖分娩的研究中的差距.
主要方法:
- 进行了系统的文献搜索,以确定相关研究.
- 包括在肥胖妇女的阴道分娩期间报告EA的研究.
- 关于研究特征和结果的数据被提取和分析.
主要成果:
- 包括11项涉及31,325名患者的研究,质量不同.
- 一项研究显示,在肥胖女性中,早期,晚期和没有EA之间的仪器分娩率和Apgar分数相似.
- 其他比较接受EA的肥胖和非肥胖妇女的研究表明,类似的仪器分娩率,但在肥胖妇女中增加了剖腹产和其他不良结果.
结论:
- 目前的文献主要侧重于EA在肥胖女性中安置的技术方面.
- 接受EA的肥胖和非肥胖女性之间的比较往往是次优的.
- 需要进一步研究,特别是研究肥胖分娩者,以充分阐明EA的风险和益处.
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