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早产和足月妊娠子痫前期引产的成功率。

Success of labor induction for pre-eclampsia at preterm and term gestational ages.

作者信息

Roland C, Warshak C R, DeFranco E A

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

J Perinatol. 2017 Jun;37(6):636-640. doi: 10.1038/jp.2017.31. Epub 2017 Mar 30.

DOI:10.1038/jp.2017.31
PMID:28358381
Abstract

OBJECTIVE

Determine the impact of gestational age (GA) on vaginal delivery following induction of labor (IOL) for pre-eclampsia, and evaluate factors that influence successful induction.

STUDY DESIGN

Population-based retrospective cohort of 1 034 552 live births in Ohio (2006-2012). The rate of vaginal delivery in women with pre-eclampsia who underwent induction was calculated with 95% confidence intervals, stratified by week of GA at birth. Factors associated with the decision to undergo IOL, and success of IOL were evaluated, and multivariable logistic regression estimated the strength of association.

RESULTS

18 296 (71.3%) of the patients who underwent IOL had a vaginal delivery. The majority achieved vaginal delivery at both preterm (66% at 23-36 weeks) and term GAs (72%). Factors most strongly associated with vaginal delivery following IOL for pre-eclampsia included prior vaginal delivery and young maternal age.

CONCLUSION

The majority of women with pre-eclampsia who undergo IOL achieve vaginal birth, even at early GAs.

摘要

目的

确定孕周(GA)对先兆子痫引产(IOL)后阴道分娩的影响,并评估影响引产成功的因素。

研究设计

基于人群的回顾性队列研究,纳入俄亥俄州1034552例活产(2006 - 2012年)。计算先兆子痫引产女性的阴道分娩率,并给出95%置信区间,按出生时的孕周分层。评估与决定进行引产及引产成功相关的因素,并通过多变量逻辑回归估计关联强度。

结果

18296例(71.3%)接受引产的患者经阴道分娩。大多数患者在早产(23 - 36周时为66%)和足月孕周时均实现了阴道分娩(72%)。与先兆子痫引产后宫内分娩最密切相关的因素包括既往阴道分娩和产妇年龄较轻。

结论

大多数接受引产的先兆子痫女性实现了阴道分娩,即使在孕周较早时也是如此。

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Clinical risk factors for preeclampsia in the 21st century.21 世纪子痫前期的临床危险因素。
Obstet Gynecol. 2014 Oct;124(4):763-770. doi: 10.1097/AOG.0000000000000451.
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Preterm induction of labor: predictors of vaginal delivery and labor curves.早产引产:阴道分娩的预测因素及产程曲线
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Rates of labor induction without medical indication are overestimated when derived from birth certificate data.如果从出生证明数据中推断,没有医学指征的引产率被高估了。
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Is preeclampsia associated with an increased risk of cesarean delivery if labor is induced?如果引产,子痫前期是否与剖宫产风险增加相关?
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Early-onset severe preeclampsia: induction of labor vs elective cesarean delivery and neonatal outcomes.早发型重度子痫前期:引产与择期剖宫产及新生儿结局
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Maternal-fetal conditions necessitating a medical intervention resulting in preterm birth.需要进行医学干预并导致早产的母胎疾病。
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Diagnosis and management of gestational hypertension and preeclampsia.妊娠期高血压疾病和子痫前期的诊断与管理
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Labor induction for the preterm severe pre-eclamptic patient: is it worth the effort?对早产重度子痫前期患者进行引产:是否值得为之努力?
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