Eclampsia in the United Kingdom 2005
Eclampsia in the United Kingdom 2005
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DOI：
10.1111/j.1471-0528.2007.01423.x
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发表时间：
2007-09-01
影响因子：
5.8
通讯作者：
Knight, M.
中科院分区：
文献类型：
--
作者：
Knight, M.
目的估计英国子痫的全国发病率，并描述自引入硫酸镁以来的管理和相关结果。设计一项基于人群的描述性研究，使用新建立的英国产科监测系统（UKOSS）。设置所有229家医院顾问-方法通过每月邮寄的UKOSS进行前瞻性病例识别。主要结果指标发病率和死亡率。死亡率与95%的置信区间。结果数据收集完成了94%的妇女。子痫的发生率为2.7例/10000例分娩（95% CI 2.4 - 3.1）。38%的女性在第一次发病前一周就有高血压和蛋白尿。99%的妇女接受了硫酸镁治疗。研究中没有女性死亡。54名妇女（26%）反复发作。119名妇女（56%）入住重症监护室或产科高依赖单位，中位数为2天（范围1 - 9）。据报道，22名妇女（10%）在子痫发作后有其他严重的发病率。已知222例婴儿（204例单胎和18例双胎）的结局。8名婴儿死产，5名死亡的新生儿期（围产期死亡率59/1000出生[95%CI 32 - 98]）。结论自1992年以来，子痫及其并发症的发病率显着下降，在英国，以下介绍的管理指南子痫和先兆子痫。这些结果与硫酸镁的随机对照试验结果一致。这项研究显示了将研究证据纳入实践的实际好处。
Objectives To estimate the national incidence of eclampsia in the UK and to describe the management and associated outcomes since the introduction of magnesium sulphate.Design A population-based descriptive study using the newly established UK Obstetric Surveillance System (UKOSS).Setting All 229 hospitals with consultant-led maternity units in the UK.Population All women in the UK delivering between February 2005 and February 2006.Methods Prospective case identification through the monthly mailing of UKOSS.Main outcome measures Incidence and mortality rates with 95% confidence intervals.Results Data collection was complete for 94% of women. The incidence of eclampsia was 2.7 cases per 10 000 births (95% Cl 2.4-3.1). Thirty-eight percent of women had established hypertension and proteinuria in the week before their first fit. Ninety-nine percent of women were treated with magnesium sulphate. No women in the study died. Fifty-four women (26%) had recurrent fits. One hundred and nineteen women (56%) were admitted to intensive care or obstetric high dependency units for a median of 2 days (range 1-9). Twenty-two women (10%) were reported to have other severe morbidity after the eclamptic episode. Outcomes were known for 222 infants (204 singletons and 18 twins). Eight infants were stillborn and five died in the neonatal period (perinatal mortality 59/1000 births [95% Cl 32-98]).Conclusions The incidence of eclampsia and its complications have decreased significantly in the UK since 1992, following the introduction of management guidelines for eclampsia and pre-eclampsia. These results are consistent with the findings of the randomised controlled trials of magnesium sulphate. This study has shown the practical benefits of the incorporation of research evidence into practice.