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儿科急诊科中妊娠及产后青少年的严重医学和社会心理并发症

Serious Medical and Psychosocial Complications in Pregnant and Postpartum Adolescents at a Pediatric Emergency Department.

作者信息

Akcan Yıldız Leman, Akça Halise, Kurt Funda, Akça Çağlar Ayla

机构信息

Pediatric Emergency Clinic, Ankara Bilkent City Hospital, Ankara, Türkiye.

出版信息

Turk Arch Pediatr. 2024 Jul 1;59(4):410-416. doi: 10.5152/TurkArchPediatr.2024.24072.

Abstract

This study aimed to describe the clinical characteristics and serious medical and psychosocial complications of pregnant and postpartum adolescent patients at a pediatric emergency department (PED). Demographic and clinical data of all pregnant and postpartum adolescents who presented to the PED of a single tertiary referral hospital between January 2020 and January 2023 were collected and documented retrospectively. Twenty-seven patients with a mean age of 16.7 ± 0.8 years were included in the study. The main presenting complaints were abdominal pain (n = 9), suspicion of pregnancy (n = 5), cough, seizure, and vomiting (3 patients each). Potentially life-threatening medical complications included stroke (n = 3), placental abruption (n = 1), and carbon monoxide intoxication (n = 1). Sexual assault (n = 4), physical assault (n = 2), recurrent pregnancies (n = 5), and suicide attempts (n = 4) were serious psychological and social complications in our patient group. Pregnant and post-partum adolescents may present to PED with serious lifethreatening complications, and permanent sequelae may occur. In addition to sexual and physical violence, various psychological problems are comorbid conditions. These patients should be managed with a multidisciplinary biopsychosocial approach, and these issues considered in their acute treatment and follow-up at emergency departments.

摘要

本研究旨在描述儿科急诊科(PED)中怀孕及产后青少年患者的临床特征以及严重的医学和心理社会并发症。回顾性收集并记录了2020年1月至2023年1月期间在一家三级转诊医院的PED就诊的所有怀孕及产后青少年的人口统计学和临床数据。27名平均年龄为16.7±0.8岁的患者纳入了本研究。主要就诊主诉为腹痛(n = 9)、疑似怀孕(n = 5)、咳嗽、癫痫发作和呕吐(各3例)。潜在危及生命的医学并发症包括中风(n = 3)、胎盘早剥(n = 1)和一氧化碳中毒(n = 1)。性侵犯(n = 4)、身体攻击(n = 2)、多次怀孕(n = 5)和自杀未遂(n = 4)是我们患者群体中严重的心理和社会并发症。怀孕及产后青少年可能因严重的危及生命的并发症就诊于PED,且可能会出现永久性后遗症。除了性暴力和身体暴力外,各种心理问题也是合并症。这些患者应以多学科生物心理社会方法进行管理,并在急诊科的急性治疗和随访中考虑这些问题。

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本文引用的文献

1
Adolescent pregnancies in Turkey: a single center experience.土耳其的青少年怀孕情况:单中心经验
Ann Saudi Med. 2024 Jan-Feb;44(1):11-17. doi: 10.5144/0256-4947.2024.11. Epub 2024 Feb 1.
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Expanding Contraceptive Access for Teens-Leveraging the Pediatric Emergency Department.扩大青少年避孕途径——利用儿科急诊。
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Ginekol Pol. 2023;94(6):500-506. doi: 10.5603/GP.a2022.0085. Epub 2022 Sep 27.

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