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胎动减少的风险因素、关联及结局:苏丹港妇产医院的一项初步横断面研究

Risk Factors, Associations, and Outcomes of Reduced Fetal Movements: A Preliminary Cross-Sectional Study at Port Sudan Maternity Hospital.

作者信息

Ali Mohammed Ali Saad, Mohammed Maysa Azhari Hamid, Abdelseid Hadeel Mohamed Muaid, Ali Eithar M

机构信息

Obstetrics and Gynecology, Red Sea University, Port Sudan, SDN.

Obstetrics and Gynecology, Red Sea State Ministry of Health, Port Sudan, SDN.

出版信息

Cureus. 2024 Nov 13;16(11):e73628. doi: 10.7759/cureus.73628. eCollection 2024 Nov.

Abstract

BACKGROUND

Reduced fetal movements (RFM) are a significant concern in obstetric care. They often indicate fetal distress and are associated with adverse perinatal outcomes such as stillbirth and intrauterine growth restriction (IUGR). While RFM is recognized as a critical marker of fetal well-being, there is a limit to the data available on its risk factors and outcomes in the Port Sudan region. This study aimed to estimate risk factors and outcomes of pregnancies at risk due to RFM.

METHODS

This was a cross-sectional hospital-based study, conducted from February to August 2022 at Port Sudan Maternity Hospital, focused on mothers with RFMs defined by the RCOG guidelines. A total of 33 cases were analyzed using a structured questionnaire, with data collected via direct interviews. Data analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY), employing descriptive statistics, frequency tables, and cross-tabulations. Ethical approval was obtained, and participant confidentiality was ensured through anonymization.

RESULTS

Most participants were married women aged 18 to 29 years, primarily housewives with diverse educational backgrounds. A minority reported medical conditions like diabetes (6.1%) and hypertension (3%), while pregnancy complications included preeclampsia (10%) and anemia (6.7%). The first episode of RFM was commonly reported before 28 weeks of gestation (34.4%). Normal vaginal delivery was the most frequent mode of birth (48.4%), with a significant number of pregnancies resulting in intrauterine fetal demise (IUFD) (53.3%). Additionally, 77.8% of newborns had five-minute APGAR scores below 7, and 42.9% had birth weights between 2.5 kg and 3.5 kg. About 12.1% of births in our study were stillbirths and all of them were preterm babies.

CONCLUSION

The study underscores the frequent serious implications of RFM on pregnancy outcomes with the majority presenting as low APGAR scores and IUFD. Early detection and timely management of RFM are crucial for improving maternal and neonatal outcomes. Tailored antenatal care (ANC) is needed to address the diverse risks associated with RFM.

摘要

背景

胎动减少(RFM)是产科护理中的一个重要问题。它们通常表明胎儿窘迫,并与围产期不良结局相关,如死产和宫内生长受限(IUGR)。虽然胎动减少被认为是胎儿健康的关键指标,但关于苏丹港地区其危险因素和结局的数据有限。本研究旨在评估因胎动减少而处于风险中的妊娠的危险因素和结局。

方法

这是一项基于医院的横断面研究,于2022年2月至8月在苏丹港妇产医院进行,研究对象为符合英国皇家妇产科医师学院(RCOG)指南定义的胎动减少的母亲。使用结构化问卷对33例病例进行分析,通过直接访谈收集数据。使用SPSS 26.0版(IBM公司,纽约州阿蒙克)进行数据分析,采用描述性统计、频率表和交叉表。获得了伦理批准,并通过匿名确保了参与者的隐私。

结果

大多数参与者是年龄在18至29岁之间的已婚女性,主要是家庭主妇,教育背景多样。少数人报告有糖尿病(6.1%)和高血压(3%)等疾病,而妊娠并发症包括先兆子痫(10%)和贫血(6.7%)。胎动减少的首次发作通常发生在妊娠28周之前(34.4%)。正常阴道分娩是最常见的分娩方式(48.4%),大量妊娠导致宫内胎儿死亡(IUFD)(53.3%)。此外,77.8%的新生儿5分钟阿氏评分低于7分,42.9%的新生儿出生体重在2.5千克至3.5千克之间。在我们的研究中,约12.1%的分娩为死产,且均为早产婴儿。

结论

该研究强调了胎动减少对妊娠结局的频繁严重影响,大多数表现为低阿氏评分和宫内胎儿死亡。早期发现并及时处理胎动减少对于改善母婴结局至关重要。需要定制产前护理(ANC)来应对与胎动减少相关的各种风险。

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Perinatal outcomes of reduced fetal movements: a cohort study.胎动减少的围产期结局:一项队列研究。
BMC Pregnancy Childbirth. 2016 Jul 19;16(1):169. doi: 10.1186/s12884-016-0964-2.
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Fetal movement counting for assessment of fetal wellbeing.胎动计数用于评估胎儿健康状况。
Cochrane Database Syst Rev. 2015 Oct 15;2015(10):CD004909. doi: 10.1002/14651858.CD004909.pub3.

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