Antepartum management and obstetric outcomes among pregnancies with Down syndrome from diagnosis to delivery
Antepartum management and obstetric outcomes among pregnancies with Down syndrome from diagnosis to delivery
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DOI：
10.1002/pd.5054
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发表时间：
2017-07-01
影响因子：
3
通讯作者：
Wilkins-Haug, Louise E.
中科院分区：
文献类型：
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作者：
Guseh, Stephanie H.;Little, Sarah E.;Wilkins-Haug, Louise E.
目的对 21 三体性持续妊娠的产科护理知之甚少。我们试图确定唐氏综合症妊娠的产科概况，以帮助指导产前管理。方法对 2003 年至 2014 年间成功分娩的 21 三体性妊娠进行了分析。我们回顾了人口统计数据、诊断测试、产前监测、产科结果和胎盘病理学。按照指示使用 T 检验、卡方检验和 Fisher 校正。结果确定了 68 例妊娠，其中 4 名妇女 (5.9%) 在妊娠期间经历了流产。其余64例妊娠中，平均分娩胎龄为36.9周，12例（17.5%）出现生长受限，51例（75.0%）出现严重异常。 35.9% 的妊娠是出于不可靠的胎儿监测而进行分娩的；其中 93% 代表与之前令人放心的监测相比发生的变化，其中 52.6% 表现出胎盘功能不全的组织病理学证据。在母亲年龄增加、存在异常或生长受限的情况下，在监测不可靠的组中，这些情况均显着更常见。 结论 在受影响的妊娠中，胎儿生长受限、胎儿状态不可靠的分娩以及胎盘功能不全的证据的发生率很高，这表明产前监测的作用。 (c) 2017 约翰·威利父子有限公司
ObjectiveLittle is known about the obstetric care of an ongoing pregnancy with trisomy 21. We sought to ascertain an obstetric profile for pregnancies with Down syndrome to help guide prenatal management.MethodPregnancies managed for delivery with trisomy 21 between 2003 and 2014 were analyzed. We reviewed demographic data, diagnostic testing, prenatal surveillance, obstetric outcomes, and placental pathology. T-test, chi-squared test, and Fisher correction were used as indicated.ResultsSixty-eight pregnancies were identified, and four women (5.9%) experienced a loss during the pregnancy. Among the remaining 64 pregnancies, the average gestational age at delivery was 36.9weeks, growth restriction was present in 12 (17.5%), and major anomalies were present in 51 (75.0%). Delivery was undertaken for non-reassuring fetal surveillance in 35.9% of the pregnancies; 93% of which represented a change from prior reassuring surveillance and 52.6% of which demonstrated histopathologic evidence of placental insufficiency. None among increased maternal age, the presence of an anomaly, or growth restriction were significantly more common in the group with non-reassuring surveillance.ConclusionThere are high rates of fetal growth restriction, delivery for non-reassuring fetal status, and evidence of placental insufficiency among affected pregnancies, suggesting a role for antepartum surveillance. (c) 2017 John Wiley & Sons, Ltd.