Hyperemesis in pregnancy: An evaluation of treatment strategies with maternal and neonatal outcomes
Hyperemesis in pregnancy: An evaluation of treatment strategies with maternal and neonatal outcomes
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DOI：
10.1016/j.ajog.2007.06.004
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发表时间：
2008-01-01
影响因子：
9.8
通讯作者：
Varner, Michael
中科院分区：
文献类型：
--
作者：
Holmgren, Calla;Aagaard-Tillery, Kjersti M.;Varner, Michael
目的：本研究的目的是评估使用的干预措施，如外周插入中心静脉导管（PICC）线或鼻胃（NG）/鼻十二指肠（ND）管与单独使用药物的妊娠管理hyperemesis.Study Design：确定受试者确认宫内妊娠，承认妊娠剧吐（HEG）1998年至2004年。然后提取医疗记录，以获取治疗相关信息。根据管理计划分配受试者：单独用药、PICC管路或NG/ND管。结果：94例患者符合研究标准，并有完整的结果数据。其中，33例放置了PICC管（35.1%），19例放置了NG/ND（20.2%），42例仅用药物治疗（44.7%）。这些组在分娩时胎龄、Apgar评分和平均出生体重方面相似。孕妇并发症显着较高的那些与PICC线。在使用PICC管的患者中，66.4%（P <0.001）的患者需要治疗感染、血栓栓塞或两者兼而有之。PICC置管并发症的校正优势比为34.5（5.09，233.73）。结论：尽管在新生儿结局方面没有差异，但与PICC置管相关的母体并发症是实质性的，这表明不应常规使用PICC置管治疗HEG患者。
OBJECTIVE: The objective of the study was to evaluate the use of interventions such as a peripherally inserted central catheters (PICC) line or nasogastric (NG)/nasoduodenal (ND) tube with the use of medications alone in the management of pregnancies with hyperemesis.STUDY DESIGN: Subjects were identified with confirmed intrauterine pregnancy, admitted with hyperemesis gravidarum (HEG) between 1998 and 2004. Medical records were then abstracted for information with regard to therapy. Subjects were assigned on the basis of the management plan: medication alone, PICC line, or NG/ND tube. Outcomes were compared between groups.RESULTS: Ninety-four patients met study criteria and had complete outcome data available. Of those, 33 had a PICC line placed (35.1%), 19 had a NG/ND placed (20.2%), and 42 were managed with medication alone (44.7%). These groups were similar with respect to gestational age at delivery, Apgar score, and mean birthweight. Maternal complications were significantly higher among those with PICC lines. Of patients managed with PICC lines, 66.4% (P < .001) required treatment for infection, thromboembolism, or both. Adjusted odds ratio for a PICC line complication was 34.5 (5.09, 233.73).CONCLUSION: Maternal complications associated with PICC line placement are substantial despite no difference in neonatal outcomes, suggesting that the use of PICC lines for treatment of HEG patients should not be routinely used.