宫前查:比较国家和国际产科成像指南
S Agudogo1,2, C McMahon3,4, D L Rolnik3,4
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
概括
目前的产科超声指导方针不充分解决血管前 (VP) 查,尽管它有可能减少死产. 包含基于证据的VP查策略的更新指南对于预防围产死亡至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 医疗成像医学成像
- 胎儿医学 胎儿医学
背景情况:
- 腹膜前置 (VP) 是一种罕见但危及生命的产科紧急情况,与高围产死亡率有关.
- 目前的国家和国际产科超声指南显示,他们对VP查的建议存在显著的变化.
研究的目的:
- 批判性地评价现有的产科超声指导方针,以对其关于前 (VP) 查的明确建议进行评价.
- 在本指南中评估VP查建议的一致性,范围和证据基础.
主要方法:
- 对20个国家和2个国际产科成像指南进行了全面审查.
- 分析了指导方针,明确提到VP,推查策略,并纳入检测方法,如胎盘带插入评估和多普勒超声波.
主要成果:
- 没有一条经过审查的指导方针明确建议进行常规的VP查.
- 虽然一些指导方针建议评估胎盘带插入,但不支持常规使用色流多普勒检测VP.
- 只有五个国家协会有专门的VP指南,其中一些建议与当前的证据不一致.
结论:
- 现有的产科成像指南经常遗漏或不充分解决VP查,尽管它已被证明对减少死产的影响.
- 迫切需要更新当前的指导方针,将基于证据的VP查策略纳入常规产科成像协议中.
- 实施结构化VP查可以显著减少可预防的围产死亡.
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