接受早期发病先兆子痫预期治疗的妇女的孕产妇和围产期结局:一项回顾性队列研究

IF 0.4 Q4 OBSTETRICS & GYNECOLOGY
N. Vijayan, A. Keepanasseril, N. Plakkal, V. Udupa, Subrahmanian Soundara Raghavan
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引用次数: 2

摘要

背景。以改善围产儿结局为目的,对早发性先兆子痫进行预期治疗,可能会增加产妇发病的风险。目标。目的:探讨早发性先兆子痫孕妇妊娠结局及其与各种危险因素的关系。方法。2014年4月至2015年6月,在印度南部的一个高等教育中心进行了一项回顾性队列研究。我们研究了201名在妊娠28 - 34周诊断为子痫前期的单胎妊娠妇女。从产妇图表中提取人口统计数据、药物和治疗细节以及分娩数据。主要结局是:(i)综合产妇结局,定义为发生任何子痫、胎盘早剥、肺水肿或肾功能衰竭;(二)围产期死亡率。在调整了其他变量后,采用Logistic回归来评估危险因素与主要结局的独立关联。结果。69名妇女(34.3%)有一种或多种综合不良产妇结局,74例(36.8%)围产期死亡。即将出现的症状(优势比(OR)=2.35)和多胎(OR=2.31)与综合不良产妇结局相关,而低出生体重和臀位阴道分娩与围产期死亡率相关。在28至30周之间诊断出先兆子痫的妇女围产期死亡率较高。诊断时的胎龄未发现与综合不良产妇结局或围产期发病率相关。结论。根据低资源环境中现有的新生儿设施,在对结果进行彻底咨询后,可以安全地考虑对早发性先兆子痫进行预期治疗,而不会增加产妇风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal and Perinatal Outcomes in Women Undergoing Expectant Management of Early-Onset Preeclampsia: A Retrospective Cohort Study
Background. Expectant management of early-onset pre-eclampsia, with the aim of improving perinatal outcomes, may increase the risk of maternal morbidity. Objective. To study the maternal and perinatal outcomes and their association with various risk factors in women undergoing expectant management for early-onset pre-eclampsia. Methods. A retrospective cohort study was carried out in a tertiary centre in south India between April 2014 and June 2015. We studied 201 women with singleton pregnancies with pre-eclampsia diagnosed between 28 and 34 weeks’ gestation. Demographic data, medication and treatment details, and delivery data were extracted from maternal charts. The primary outcomes were: (i) composite maternal outcomes, defined as the development of any of eclampsia, abruptio placentae, pulmonary oedema or renal failure; and (ii) perinatal mortality. Logistic regression was used to assess the independent association risk factors with primary outcomes, after adjusting for other variables. Results. Sixty-nine women (34.3%) had one or more of the composite adverse maternal outcomes, and there were 74 (36.8%) cases of perinatal mortality. The presence of imminent symptoms (odds ratio (OR)=2.35) and multiparity (OR=2.31) were associated with composite adverse maternal outcomes, whereas low birth weight and breech vaginal delivery were associated with perinatal mortality. Perinatal mortality was higher in women with pre-eclampsia diagnosed between 28 and 30 weeks. Gestational age at diagnosis was not found to be associated with composite adverse maternal outcomes or perinatal morbidity. Conclusion. Expectant management in early-onset pre-eclampsia can be safely considered without increasing maternal risk, after thorough counselling about outcomes, based on the available neonatal facilities in low-resource settings.
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来源期刊
South African Journal of Obstetrics and Gynaecology
South African Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
5
审稿时长
15 weeks
期刊介绍: The SAJOG is a tri-annual, general specialist obstetrics and gynaecology journal that publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. The journal carries original research articles, editorials, clinical practice, personal opinion, South Africa health-related news, obituaries and general correspondence.
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