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胎粪污染羊水与 37-39 周和 40-42 周妊娠不良结局的相关性。

Correlation of Meconium-Stained Amniotic Fluid and Adverse Pregnancy Outcomes between 37 to 39 and 40 to 42 Weeks of Gestational Age.

机构信息

Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.

出版信息

Am J Perinatol. 2024 May;41(S 01):e1591-e1598. doi: 10.1055/a-2053-8018. Epub 2023 Mar 14.

Abstract

OBJECTIVE

We aimed at assessing the association between meconium-stained amniotic fluid (MSAF) and adverse maternal and neonatal outcomes in early-term versus late-term pregnancies.

STUDY DESIGN

Early-term pregnancies (37-39 weeks of gestation) presented with MSAF were compared with late-term (40-42 weeks of gestation) pregnancies with MSAF. The groups were compared with respect to background characteristics, maternal outcomes, and neonatal outcomes. The composite neonatal outcome was the primary outcome of the study, and secondary outcomes included maternal and neonatal outcomes.

RESULTS

The early-term group comprised 239 women, compared with 362 women in the late-term group. The primary outcome did not differ between groups. We found a higher prevalence of gestational diabetes (8.37 vs. 3%, < 0.05), a shorter second stage of labor (45.61 ± 54.67 vs. 65.82 ± 62.99 minutes, < 0.05), and a longer hospital stay (2.84 ± 2.21 vs. 2.53 ± 1.26 days, < 0.05) in the early-term group. Other maternal and neonatal characteristics and outcomes were not significantly different between the two groups.

CONCLUSION

In term pregnancies complicated by MSAF, adverse neonatal and maternal delivery outcomes are equivalent, regardless of gestational age, and therefore, any term pregnancy complicated by MSAF should be considered high risk and managed appropriately.

KEY POINTS

· In term pregnancies complicated by MSAF, adverse neonatal and maternal delivery outcomes are equivalent, regardless of gestational age.. · Any term pregnancy complicated by MSAF should be considered high risk and managed appropriately.. · Deliveries presented with MSAF are typically considered to be high risk and require close fetal surveillance by a certified team with resuscitation skills.. · Our study may help to reduce the need for a close fetal surveillance and delivery interventions if MSAF is not identified as a risk factor for adverse outcomes in late-term pregnancies..

摘要

目的

评估早孕期和晚期孕期中胎粪污染羊水(MSAF)与不良母婴结局的关系。

研究设计

将早孕期(37-39 周)胎粪污染羊水的病例与晚期孕期(40-42 周)胎粪污染羊水的病例进行比较。比较两组的背景特征、母婴结局和新生儿结局。复合新生儿结局是本研究的主要结局,次要结局包括母婴结局。

结果

早孕期组有 239 名妇女,晚孕期组有 362 名妇女。两组主要结局无差异。我们发现早孕期组妊娠期糖尿病的发生率较高(8.37%比 3%,<0.05),第二产程较短(45.61±54.67 分钟比 65.82±62.99 分钟,<0.05),住院时间较长(2.84±2.21 天比 2.53±1.26 天,<0.05)。两组其他母婴特征和结局无显著差异。

结论

在 MSAF 合并足月妊娠中,不良新生儿和产妇分娩结局是等同的,与胎龄无关,因此,任何 MSAF 合并足月妊娠都应被视为高危妊娠,应进行适当管理。

重点

  1. 在 MSAF 合并足月妊娠中,不良新生儿和产妇分娩结局是等同的,与胎龄无关。

  2. 任何 MSAF 合并足月妊娠都应被视为高危妊娠,并进行适当管理。

  3. 出现 MSAF 的分娩通常被认为是高危的,需要由具有复苏技能的认证团队进行密切的胎儿监测。

  4. 如果 MSAF 不是晚期妊娠不良结局的危险因素,我们的研究可能有助于减少对密切胎儿监测和分娩干预的需求。

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