Fetal and maternal surveillance in high-risk pregnancy: tools, timing, and trends.

Q3 Medicine
Madalina Piron-Dumitrascu, Dragos Cretoiu, Valentin Nicolae Varlas, Nicolae Suciu
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引用次数: 0

Abstract

According to WHO statistics, stillbirths represent an incompletely elucidated, partially neglected problem, resulting in millions of pregnancies per year globally. This phenomenon has a major emotional impact on parents and society, as well as an additional economic effort on the part of health services. Stratification of high-risk pregnancies could be followed by a decrease in perinatal mortality through careful monitoring and possible obstetric interventions in selected cases. Identification of risk factors, assessment of genetic causes, planning of imaging monitoring strategy, cardiotocography, and therapeutic management can contribute to a decrease in the number of stillbirths. In this narrative review, we aimed to assess the current status of fetal and maternal surveillance in high-risk pregnancies and the role of identifying fetal movements associated with the risk of stillbirth. Recommendations for routine monitoring of fetal movement are warranted in high-risk pregnancies, particularly those with placental pathology or small for gestational age (SGA)/FGR (fetal growth restriction) assessed by ultrasound or by analysis of various biomarkers. Current methods for fetal movement counting do not demonstrate high sensitivity and specificity, underscoring the need for further research. Identifying the main risk factors for stillbirth and stratifying fetuses at high risk will contribute to improving mater-nal-fetal outcomes and better management of health system resources.

高危妊娠的胎儿和母体监测:工具、时机和趋势。
根据世卫组织的统计数据,死产是一个未完全阐明、部分被忽视的问题,每年导致全球数百万人怀孕。这一现象对父母和社会产生了重大的情感影响,也给卫生服务部门带来了额外的经济负担。对高危妊娠进行分层后,可通过仔细监测和在选定病例中采取可能的产科干预措施,降低围产期死亡率。确定危险因素,评估遗传原因,规划成像监测策略,心脏摄影和治疗管理可以有助于减少死产的数量。在这篇叙述性综述中,我们旨在评估高危妊娠中胎儿和母体监测的现状,以及识别与死产风险相关的胎儿运动的作用。建议对高危妊娠进行常规监测是必要的,特别是那些有胎盘病理或胎龄小(SGA)/FGR(胎儿生长受限)的孕妇,通过超声或分析各种生物标志物进行评估。目前的胎动计数方法的灵敏度和特异性不高,需要进一步的研究。确定死产的主要危险因素并对高危胎儿进行分层将有助于改善母胎结局和更好地管理卫生系统资源。
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来源期刊
Journal of Medicine and Life
Journal of Medicine and Life Medicine-Medicine (all)
CiteScore
1.90
自引率
0.00%
发文量
202
期刊介绍: The Journal of Medicine and Life publishes peer-reviewed articles from various fields of medicine and life sciences, including original research, systematic reviews, special reports, case presentations, major medical breakthroughs and letters to the editor. The Journal focuses on current matters that lie at the intersection of biomedical science and clinical practice and strives to present this information to inform health care delivery and improve patient outcomes. Papers addressing topics such as neuroprotection, neurorehabilitation, neuroplasticity, and neuroregeneration are particularly encouraged, as part of the Journal''s continuous interest in neuroscience research. The Editorial Board of the Journal of Medicine and Life is open to consider manuscripts from all levels of research and areas of biological sciences, including fundamental, experimental or clinical research and matters of public health. As part of our pledge to promote an educational and community-building environment, our issues feature sections designated to informing our readers regarding exciting international congresses, teaching courses and relevant institutional-level events.
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