Perinatal Diagnostic Center, Central Baptist Hospital, Lexington, KY, USA.
Am J Obstet Gynecol. 2011 Jan;204(1):44.e1-5. doi: 10.1016/j.ajog.2010.08.030.
To examine the frequency of elective delivery and neonatal outcomes in women with stable mild gestational hypertension delivering late preterm.
The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.
One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered. Among the 1251 women delivered electively, 25.5% were late preterm, 24.4% at 37⁰(/)⁷-37⁶(/)⁷ weeks and 50.1% at ≥38⁰(/)⁷ weeks' gestation. Neonatal intensive care unit admission, ventilatory assistance, and respiratory distress syndrome were more common in late-preterm infants. There was no maternal/perinatal mortality.
We found that 25.5% of patients with stable mild gestational hypertension, without any maternal or fetal complication, had iatrogenic elective late-preterm delivery. This practice also was associated with increased rates of neonatal complications and neonatal length of stay.
研究无蛋白尿的稳定轻度妊娠期高血压孕妇在孕晚期早产时选择性分娩的频率和新生儿结局。
从一个大型国家数据库中研究了 1995 年至 2007 年间，孕 34⁰(/)⁷-36⁶(/)⁷ 周（晚期早产）、37⁰(/)⁷-37⁶(/)⁷ 周和≥38⁰(/)⁷ 周时，单纯性轻妊娠期高血压且无蛋白尿的单胎妊娠中，选择性分娩的频率和新生儿结局。
研究了 1858 例患者：607 例（33%）因母婴/胎儿原因分娩，1251 例（67%）选择性分娩。在 1251 例选择性分娩的妇女中，25.5%为晚期早产，24.4%在 37⁰(/)⁷-37⁶(/)⁷ 周，50.1%在≥38⁰(/)⁷ 周。晚期早产儿需要入住新生儿重症监护病房、呼吸机辅助和呼吸窘迫综合征的比例更高。没有母婴围产期死亡。
我们发现，25.5%的稳定轻度妊娠期高血压且无任何母婴并发症的患者，存在医源性选择性晚期早产分娩。这种做法也与新生儿并发症和新生儿住院时间的增加有关。
