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孕期的轻微创伤会影响围产期结局吗?

Does minor trauma in pregnancy affect perinatal outcome?

作者信息

Garmi Gali, Marjieh Mary, Salim Raed

机构信息

Department of Obstetrics and Gynecology, Emek Medical Center, 18101, Afula, Israel.

出版信息

Arch Gynecol Obstet. 2014 Oct;290(4):635-41. doi: 10.1007/s00404-014-3256-y. Epub 2014 May 6.

Abstract

PURPOSE

To investigate pregnancy outcome after minor trauma and to identify risk factors at admission that may predict adverse pregnancy outcome.

METHODS

A retrospective study held between January-2005 and December-2011. Pregnant women at 23 weeks or more, who were admitted due to minor trauma, were included. A standard protocol was applied: physical examination, lab tests and a fetal heart rate monitoring (FHRM) and tocometer for 1 h. In cases of symptomatic women, abnormal FHRM or presence of uterine contractions, the length of monitoring was extended. All women were admitted for 24 h of observation. The primary outcome was a composite adverse outcome that included at least one of the following: placental abruption, preterm birth and birthweight <2,500 g. To investigate pregnancy outcome and identify risk factors that may predict pregnancy outcome, matched (1:2) non-trauma controls were included. Risk factors examined included maternal obstetric variables, complaints at admission, clinical findings, lab test results, FHRM and tocometer findings.

RESULTS

A total of 512 women with minor trauma and 1,024 non-trauma controls were included. Composite outcome occurred in 48 (9.4 %) and 131 (12.9 %) of the study and the control groups, respectively (p = 0.04; OR 0.71; 95 % CI, 0.5-0.99). None of the parameters examined at admission predicted the occurrence of the composite outcome.

CONCLUSION

Pregnant women after minor trauma have a favorable pregnancy outcome. None of the parameters examined at admission were predictive of adverse outcome. Extensive evaluation at admission and observation for 24 h are probably unnecessary following minor trauma, particularly for asymptomatic women.

摘要

目的

研究轻度创伤后的妊娠结局,并确定入院时可能预测不良妊娠结局的危险因素。

方法

进行一项回顾性研究,时间跨度为2005年1月至2011年12月。纳入孕周23周及以上因轻度创伤入院的孕妇。采用标准方案:体格检查、实验室检查、1小时的胎儿心率监测(FHRM)和宫缩图监测。对于有症状的女性、FHRM异常或有子宫收缩的情况,监测时间延长。所有女性均入院观察24小时。主要结局是复合不良结局,包括以下至少一项:胎盘早剥、早产和出生体重<2500g。为了研究妊娠结局并确定可能预测妊娠结局的危险因素,纳入了匹配的(1:2)非创伤对照组。检查的危险因素包括产妇产科变量、入院时的主诉、临床检查结果、实验室检查结果、FHRM和宫缩图检查结果。

结果

共纳入512例轻度创伤女性和1024例非创伤对照组。研究组和对照组的复合结局分别发生在48例(9.4%)和131例(12.9%)中(p = 0.04;OR 0.71;95% CI,0.5 - 0.99)。入院时检查的参数均未预测复合结局的发生。

结论

轻度创伤后的孕妇妊娠结局良好。入院时检查的参数均不能预测不良结局。轻度创伤后,尤其是无症状女性,入院时进行广泛评估和24小时观察可能没有必要。

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