《孕期和产褥期孕产妇衰竭指南(2019)》要点解读

Interpretation of Maternal Collapse in Pregnancy and the Puerperium:Green-Top Guideline No.56

2019年12月,英国皇家妇产科医师学会(RCOG)发布《孕期和产褥期孕产妇衰竭指南(2019)》(Maternal Collapse in Pregnancy and the Puerperium:Green-Top Guideline No.56),总结孕期和产褥期孕产妇衰竭(MCPP)的相关循证医学证据,详细探讨如何早期识别发生MCPP高风险与导致MCPP的病因、影响MCPP孕产妇复苏的孕期生理与解剖生理变化,以及如何进行MCPP最佳初始和持续管理,并对其围死亡期剖宫产术(PMCS)进行深入描述。该指南还特别强调MCPP救护的多学科团队人员组成与职责。笔者拟结合我国产科临床实践,对该指南涉及的MCPP风险如何早期识别及其病因、影响复苏的孕期生理与解剖生理变化、最佳初步处理措施、PMCS、持续管理、对于母儿的影响、多学科救护团队人员组成等产科临床关注的相关问题要点,进行解读、讨论。

The Royal College of Obstetricians and Gynaecologists(RCOG)recommends the second edition of Maternal Collapse in Pregnancy and the Puerperium:Green-Top Guideline No.56 on December 2019.This guideline summarizes the evidence-based medical evidence related to maternal collapse in pregnancy and puerperium(MCPP),discusses how to identify pregnant women with high risk of MCPP and the different causes of MCPP,and the physiological and anatomical changes during pregnancy that affect the recovery of collapse in detail,and describes how to carry out the best initial and continuous management of MCPP and perimortem cesarean section(PMCS).In addition,it also emphasizes composition and responsibilities of a multidisciplinary rescue team for MCPP.In this article,with the combination of clinical practice of obstetrics in China,we intend to interpret and discuss key issues related to obstetrics in this guideline,such as how to identify the risks and causes of MCPP,the physiological and anatomical changes during pregnancy that affect recovery of collapse,the best initial management measures,PMCS,continuous management,the impacts of MCPP on mothers and children,the rescue team and so on.