Repke John T, Power Michael L, Holzman Gerald B, Schulkin Jay
Department of Obstetrics and Gynecology, University of Nebraska Medical Center, 983255 Nebraska Medical Center, Omaha, NE 68198-3255, USA.
J Reprod Med. 2002 Jun;47(6):472-6.
To examine the knowledge and practice patterns of obstetrician-gynecologists concerning management of hypertensive disorders of pregnancy.
Surveys were mailed to 1,116 fellows of the American College of Obstetrics and Gynecology; 416 of them constituted the Collaborative Ambulatory Research Network. Seven hundred more were chosen at random. The survey contained questions on physician and patient demography and on knowledge and practice patterns concerning management of various hypertensive disorders during pregnancy.
A total of 401 completed surveys were analyzed. There was no difference between respondents and nonrespondents in either sex ratio (P = .410) or age (46.9 +/- 0.4 versus 48.1 +/- 0.4 years, P = .131). Most respondents (84.5%) would manage mild preeclampsia on an outpatient basis, and most (58.6%) usually managed preeclampsia independently. There was considerable variation in clinical practice. For example, about one of four respondents (27.4%) do not use seizure prophylaxis during labor in mild preeclampsia. Among physicians who do utilize magnesium sulfate for seizure prophylaxis, the mean standard loading dose was 4.5 +/- .1 g intravenously. More than half the respondents (54.9%) would employ preeclampsia prevention procedures. Most respondents (74.6%) said that there is a role for management of severe preeclampsia remote from term. Intrauterine growth restriction would be used as an indication for immediate delivery by 60.6% of respondents; female physicians were more likely to use intrauterine growth retardation as an indication for immediate delivery (chi 2 = 5.7, P = .017).
探讨妇产科医生对妊娠期高血压疾病管理的知识和实践模式。
向1116名美国妇产科医师协会会员邮寄调查问卷；其中416人构成协作门诊研究网络。另外随机选择700人。该调查包含有关医生和患者人口统计学以及妊娠期各种高血压疾病管理的知识和实践模式的问题。
共分析了401份完成的调查问卷。在性别比例（P = 0.410）或年龄（46.9±0.4岁对48.1±0.4岁，P = 0.131）方面，应答者和未应答者之间没有差异。大多数应答者（84.5%）会在门诊管理轻度子痫前期，大多数（58.6%）通常独立管理子痫前期。临床实践存在很大差异。例如，约四分之一的应答者（27.4%）在轻度子痫前期分娩期间不使用预防惊厥的药物。在确实使用硫酸镁预防惊厥的医生中，平均标准负荷剂量为静脉注射4.5±0.1g。超过一半的应答者（54.9%）会采用子痫前期预防措施。大多数应答者（74.6%）表示，对于远离足月的重度子痫前期的管理有作用。60.6%的应答者会将胎儿生长受限作为立即分娩的指征；女医生更有可能将胎儿生长受限作为立即分娩的指征（χ² = 5.7，P = 0.017）。
