代谢综合征孕妇的胎儿-产妇合并症--一项基于医院的研究

Syed Bassit, Nowsheen Khan
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摘要

背景:代谢综合征(MetS)是一系列代谢紊乱,包括腹部肥胖、糖耐量和胰岛素代谢受损、高血压和血脂异常。[1,8,9] 孕前代谢变化不仅是妊娠期、妊娠后和产后并发症的决定因素,也是围产期不当结局的原因。孕前超重会增加妊娠并发症的风险,肥胖是导致巨大儿、剖宫产、妊娠高血压、早产、胎儿宫内生长受限、先天畸形、胎儿宫内死亡等的独立危险因素。[2,7]妊娠期 MetS 特征的出现也可能对胎儿造成伤害。研究方法根据 NCEPATP III 实验室和临床标准中的代谢综合征妊娠适应标准诊断代谢综合征。对病例进行全程跟踪,直至分娩,并记录母体和胎儿的并发症。结果:样本量为 100 名妊娠不足 20 周的代谢综合征患者和 100 名对照组,对照组为妊娠不足 20 周且无任何合并症的正常孕妇。平均年龄为 29-32 岁。平均孕周为 13-16 周。病例中的 LSCS 明显高于对照组。与对照组相比,病例中的 APH、妊娠诱发高血压、子痫前期、妊娠糖尿病的发病率明显较高。与对照组相比,病例中早产、IUGR、巨大儿的比例明显更高。结论妊娠代谢综合征及其相关并发症对母体和胎儿的健康有很大影响。仔细询问病史并进行检查、及时进行适当的检查、进行适当的监测和随访、服用必要的药物并优化控制所有参数,将有助于改善母体和胎儿的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FETO-MATERNAL COMLICATIONS IN PREGANCY WITH METABOLIC SYNDROME -A HOSPITAL BASED STUDY
Background: Being first identified by Reaven as a syndrome in 1988,[14] metabolic syndrome (MetS) is a series of metabolic disorders, including abdominal obesity, impaired glucose tolerance and insulin metabolism, hypertension, and dyslipidaemia. [1,8,9] Prepregnancy metabolic changes are not only the determinant of complications during pregnancy, after pregnancy, during postpartum life, but the reasons for inappropriate perinatal outcomes. Overweight women before pregnancy increases the risk of pregnancy complications obesity turns out to be an independent risk factor for macrosomia,cesarean section,pregnancy-induced hypertension, preterm delivery, intrauterine growth restriction, congenital malformation, intrauterine foetal death,etc. [2,7]The emergence of MetS characteristics during pregnancy may also harm the fetus.[4]This study was conducted to study the maternal and foetal outcome in pregnant women with Metabolic Syndrome. Methods: Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy till delivery and maternal and foetal complications were recorded. Results: Sample size was 100patients less than 20 weeks of gestation with metabolic syndrome and 100 controls which were normal pregnant patients less than 20 weeks of gestation without any comorbidities. The mean age was 29-32 years. The mean gestational age was 13-16 weeks. LSCS was significantly higher in cases than controls. APH, Pregnancy Induced Hypertension, Pre-eclampsia, Gestational Diabetes Mellitus was significantly higher in cases as compared to controls. Preterm, IUGR, Macrosomia was significantly higher in cases as compared to controls. Conclusion: Metabolic syndrome and its associated complications in pregnancy have a strong effect on the maternal and the fetal well-being. A careful history and examination,proper and timely investigations and proper monitoring and follow up with required medication and optimal control of all the parameters will result in better maternal and foetal outcome.
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