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埃塞俄比亚城市教学转诊医院产妇羊水胎粪污染的围产儿结局。

Perinatal outcome of meconium stained amniotic fluid among labouring mothers at teaching referral hospital in urban Ethiopia.

机构信息

Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Department of Health, Behavior, and Society, Jimma University, Jimma, Ethiopia.

出版信息

PLoS One. 2020 Nov 13;15(11):e0242025. doi: 10.1371/journal.pone.0242025. eCollection 2020.

Abstract

OBJECTIVE

To determine the perinatal outcome of labouring mothers with meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at teaching referral hospital in urban Ethiopia.

METHODS

A prospective cohort study was conducted among labouring mothers with meconium-stained amniotic fluid from July 1 to December 30, 2019. Data was collected with pretested structured questionnaires. A Chi-square test used to check statistical associations between variables. Those variables with a p-value of less than 0.05 were selected for cross-tabulation and binary logistic regression. P-value set at 0.05, and 95% CI was used to determine the significance of the association. Relative risk was used to determine the strength and direction of the association.

RESULT

Among 438 participants, there where 75(52.1%) primigravida in a stained fluid group compared to112 (38.5%) of the non-stained fluid group. Labour was induced in 25 (17.4%) of the stained fluid group compared to 25(8.6%) of a non-stained fluid group and has a statistically significant association with meconium staining. The stained fluid group was twice more likely to undergo operative delivery compared with a non-stained fluid group. There were more low Apgar scores at birth (36.8% versus 13.2%), birth asphyxias (9% versus 2.4%), neonatal sepsis (1% versus 5.6%), neonatal death (1% versus 9%), and increased admissions to neonatal intensive care unit (6.2% versus 21.5%) among the meconium-stained group as compared to the non-stained group. Meconium aspiration syndrome was seen in 9(6.3%) of the stained fluid group.

CONCLUSION

Meconium-stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid.

摘要

目的

在埃塞俄比亚城市的教学转诊医院,比较有胎粪污染羊水(MSAF)的产妇与羊水清亮的产妇的围产结局。

方法

对 2019 年 7 月 1 日至 12 月 30 日期间有胎粪污染羊水的产妇进行前瞻性队列研究。使用预测试的结构化问卷收集数据。卡方检验用于检查变量之间的统计关联。选择 p 值小于 0.05 的变量进行交叉表和二项逻辑回归。p 值设为 0.05,95%CI 用于确定关联的显著性。相对风险用于确定关联的强度和方向。

结果

在 438 名参与者中,胎粪污染组中有 75 名(52.1%)初产妇,而清亮组中有 112 名(38.5%)。胎粪污染组中有 25 名(17.4%)产妇进行了引产,而清亮组中有 25 名(8.6%)产妇进行了引产,两者具有统计学显著关联。胎粪污染组行剖宫产的可能性是清亮组的两倍。胎粪污染组出生时低 Apgar 评分(36.8%比 13.2%)、出生窒息(9%比 2.4%)、新生儿败血症(1%比 5.6%)、新生儿死亡(1%比 9%)和新生儿重症监护病房入院率(6.2%比 21.5%)更高。胎粪污染组中有 9 名(6.3%)患儿发生胎粪吸入综合征。

结论

与羊水清亮组相比,胎粪污染羊水与剖宫产、出生窒息、新生儿败血症和新生儿重症监护病房入院率增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39fa/7665744/3bcc37afcb83/pone.0242025.g001.jpg

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