Booth Jessica M, Tonidandel Ashley M
Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Clin Obstet Gynecol. 2017 Jun;60(2):405-417. doi: 10.1097/GRF.0000000000000279.
The prevalence of obstructive sleep apnea is unknown during pregnancy, but the syndrome is likely underdiagnosed and rising in frequency along with the obesity epidemic. Obstructive sleep apnea is associated with adverse outcomes, including hypertensive disorders of pregnancy, gestational diabetes, preterm, and cesarean delivery. Obese pregnant women should be screened and referred to a sleep medicine specialist for evaluation. Continuous positive airway pressure is the treatment of choice with demonstrated safety and compliance in pregnancy. Early anesthesia consultation allows for preparation and implementation of a peripartum plan that includes early labor analgesia, avoidance of respiratory depressants, and closer monitoring of oxygenation.
妊娠期阻塞性睡眠呼吸暂停的患病率尚不清楚,但该综合征可能未得到充分诊断,且随着肥胖症的流行,其发病率正在上升。阻塞性睡眠呼吸暂停与不良结局相关,包括妊娠期高血压疾病、妊娠期糖尿病、早产和剖宫产。肥胖孕妇应接受筛查,并转诊至睡眠医学专家处进行评估。持续气道正压通气是治疗的首选方法,已证明其在妊娠期间具有安全性和依从性。早期麻醉会诊有助于制定和实施围产期计划,包括早期分娩镇痛、避免使用呼吸抑制剂以及密切监测氧合情况。