透析和怀孕:优化治疗以获得最佳的孕产妇和胎儿结果
Shreepriya Mangalgi1, Silvi Shah2
1Division of Nephrology, Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
概括
在透析中患有末期病 (ESKD) 的女性怀孕的风险很高. 透析和多学科护理的优化改善了母亲和胎儿的结果,增加了活产率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 产科 产科 产科 产科 产科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 需要透析的末期脏病 (ESKD) 妇女的怀孕对母亲和胎儿构成重大风险.
- 透析和产科护理的进步导致了成功怀孕的增加,但并发症仍然很常见.
研究的目的:
- 审查当前关于孕产力,透析策略和ESKD透析孕妇的孕妇和胎儿之间的结果的证据.
- 突出优化透析和多学科护理这一高风险人群的实际考虑.
主要方法:
- 对当前证据的系统审查.
- 综合了关于生育,透析策略和母胎结局的数据.
- 确定临床管理的实际考虑.
主要成果:
- 透析强化 (更长的时间,更低的BUN) 与更好的妊娠年龄,出生体重和活产率相关.
- 孕产妇的风险包括早孕流产,孕前和剖腹产.
- 胎儿风险包括早产,低出生体重和高NICU利用率.
- 多学科护理对于管理这些复杂的怀孕至关重要.
结论:
- 优化置换疗法,个性化透析处方和多学科护理对于改善结果至关重要.
- 解决进入密集透析和专科护理的差异至关重要.
- 未来的研究应该集中在产科科培训,腹腔透析和怀孕期间的家庭血液透析.
相关概念视频
Peritoneal Dialysis III: Nursing Management
1.2K
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
1.2K
Dialysis
1.7K
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.7K
Dialysis
2.0K
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
2.0K
Hemodialysis III: Nursing Management
1.3K
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
1.3K
Acute Kidney Injury V: Interprofessional Care
436
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
436
Chronic Kidney Disease III: Interprofessional Care
561
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
561


