AbstractObjectives: The purpose was to correlate the use of regional analgesia/anasthesia among women with different degrees of thrombocytopenia relative to women with normal platelet counts, and note maternal and neonatal outcome, and mode of delivery.Methods: A case-control paradigm was developed based on women who delivered during 2007–2011 with platelet counts ≤80?000/mm3. For each woman in this “severe” thrombocytopenic group, an age- and parity-matched control was found who delivered a singleton within the same year but whose platelets were either 81?000–150?000/mm3 (“moderate” thrombocytopenia) or ≥151?000/mm3 (normal platelet counts).Results: 168 women were identified for each group; mean maternal age (28.4 years), mean gravidity (4.3), mean parity (3.7), mean gestational age (39.2 weeks) and mean birth weight (3283?g) were comparable. However, only in the severe thrombocytopenic women were there very early preterm deliveries, lowest birth weight, lowest Apgar scores, the greatest number with serious post-partum hemorrhage (>500?ml); use of regional analgesia/anesthesia was lowest, and percent cesarean sections highest.Conclusions: This study highlights potential for adverse maternal outcome of post-partum hemorrhage and adverse neonatal outcomes of prematurity, low birth weight, and low Apgar scores (but not neonatal death), and limited regional analgesia/anesthesia in women who present at delivery with severe (≤80?000/mm3) thrombocytopenia. 相似文献
Aim: To investigate the serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord (NC) and to compare the results with healthy deliveries (without NC).
Methods: This prospective controlled study included 48 pregnant women complicated by NC and 48 similar gestational aged healthy pregnant women during labor. Fetal umbilical cord serum samples were collected during labor and the thiol/disulphide homeostasis was measured by using an automated assay method. The patients were followed up until end of the delivery and perinatal outcomes were recorded.
Results: Fetal umbilical cord native thiol, total thiol, and disulphide levels as well as disulphide/native thiol and disulphide/total thiol ratios are impaired in labor with the presence of NC. There were no statistically significant differences in terms of maternal and gestational age at delivery and maternal number of gravida and parity, fetal gender, fifth Apgar scores <7, mode of delivery and fetal birth weight between groups. The group of patients with NC had higher emergency C/S numbers indicated for fetal distress and lower first Apgar scores <7. There were no neonatal intensive care unit admissions among these babies.
Conclusions: Maternal serum thiol/disulphide homeostasis reflect transient effects of NC during labor regardless of labor type. Vaginal delivery can be safely and successfully performed in pregnancies complicated with NC. 相似文献
目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apgar评分对于预测新生儿窒息并发症进行真实性的评价。结果1 min Apgar评分与脐动脉血pH值相关(χ2=278.13,P<0.05)。脐动脉血pH值对于预测窒息并发症较Apgar评分有更高的敏感度及特异度。pH值异常发生比例与HIE程度有关,随HIE程度的提高而增加(χ2=4.437,P<0.05)。结论脐动脉血pH值能客观评价新生儿出生时的状况,对监测新生儿预后、早期采取有效措施防治窒息并发症有指导意义。 相似文献