在接受诱导并进入活性阶段的患者中,延长潜伏阶段是否重要?
Kira A Bromwich1,2, Rebecca F Hamm2,3, Lisa D Levine2,3
1Department of OB/GYN, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
概括
在劳动诱导期间长时间的潜伏阶段增加了剖腹产 (CD) 和孕产妇/新生儿并发症的风险. 然而,大多数患者仍然可以通过阴道分娩,尽管发病率较高.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 劳动和交付管理 劳动和交付管理
背景情况:
- 诱导分娩 (IOL) 对于有不良子宫的孕期是常见的.
- 劳动的潜伏阶段可能会延长,引发对结果的担忧.
- 了解与长期潜伏期相关的风险对于临床决策至关重要.
研究的目的:
- 为了评估延长的潜伏期与在进行分娩诱导的患者中剖腹产 (CD) 的风险之间的联系.
- 评估长期潜伏期对孕产妇和新生儿发病率的影响.
主要方法:
- 一项前性队列研究 (2018-2022) 的二次分析,包括经过IOL的单期妊娠.
- 长期潜伏阶段定义为≥12小时后<6厘米扩张,膜破裂和催产素,在活动分娩 (≥6厘米) 之前.
- 使用多变量逻辑回归来分析初级 (CD) 和二次结果 (劳动停产,发病率),按平价分层.
主要成果:
- 长期潜伏阶段发生在6.3%的到达活跃分娩的患者中.
- 患有延长潜伏期的患者患病率较高 (25.2%比9.9%),临床肌炎和母婴综合发病率的风险增加.
- 在调整后,CD风险的增加是显著的,主要观察到无卵性患者.
结论:
- 诱导分娩的长期潜伏阶段与剖腹产和孕产妇/新生儿发病率的上升有关,特别是在无胎儿的个体中.
- 尽管风险增加,但大多数患有长期潜伏期的患者可以通过阴道分娩.
- 临床监测和管理应考虑与长期潜伏阶段相关的并发症增加的可能性.
相关概念视频
01:28Pulmonary Tuberculosis V
530
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
530
01:22Stages of General Anesthesia
1.4K
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.4K
01:26Stages of Infection
64.8K
Stages of infection describe what happens to a susceptible host once a pathogen invades the human body. The stages of infection are incubation, prodromal, illness, stage of decline, and convalescence. The incubation stage is the period from exposure to a pathogen until symptoms start. The infected person is unaware of impending illness as the pathogens grow and multiply within the body. The duration may vary depending on the type of infection. The incubation period of measles averages ten to...
64.8K
01:26Psychosis: Goals of Pharmacotherapy
449
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
449
01:11Clinical Trials: Overview
4.5K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
4.5K
01:20Desensitization and Tachyphylaxis
3.0K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
3.0K