Kang H W, Kim W Y, Jin S J, Kim Y H, Min T J, Lee Y S, Kim J H
Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea.
J Int Med Res. 2019 Sep;47(9):4365-4373. doi: 10.1177/0300060519859749. Epub 2019 Jul 23.
The number of high-risk pregnancies is increasing in tertiary medical centers. Therefore, we investigated perioperative outcomes based on risk factors to ascertain proper maternal and neonatal management.
We reviewed the medical records of patients receiving cesarean sections over an 8-year period. Clinical parameters for anesthesia and the neonatal outcome were compared among high-risk groups after subdivision by the number of clinical risk factors. The groups were as follows: group A (one risk factor), group B (two risk factors), and group C (three or more risk factors).
Patient age, estimated blood loss (EBL), and volume of transfused red blood cell (RBC) were higher in group B than group A. Birth weight, 1- and 5-minute Apgar scores, and gestational age were lower while the frequency of neonatal intensive care unit (NICU) admission was higher in group B than group A. Group C patients were significantly older than group A or B patients. Birth weight, 1- and 5-minute Apgar scores and gestational age were significantly lower while frequency of NICU admission was higher in group C than group A and B.
The number of maternal risk factors was positively associated with adverse outcomes in the neonates.
三级医疗中心高危妊娠的数量正在增加。因此，我们基于风险因素调查围手术期结局，以确定适当的孕产妇和新生儿管理措施。
我们回顾了8年间接受剖宫产手术患者的病历。在根据临床风险因素数量细分的高危组中，比较麻醉的临床参数和新生儿结局。分组如下：A组（一个风险因素）、B组（两个风险因素）和C组（三个或更多风险因素）。
B组患者的年龄、估计失血量（EBL）和输注红细胞（RBC）的量均高于A组。B组的出生体重、1分钟和5分钟阿氏评分以及孕周均低于A组，而新生儿重症监护病房（NICU）入院频率高于A组。C组患者明显比A组或B组患者年龄大。C组的出生体重、1分钟和5分钟阿氏评分以及孕周明显低于A组和B组，而NICU入院频率高于A组和B组。
孕产妇风险因素的数量与新生儿不良结局呈正相关。
