_fibronectin testing for suspected preterm labour in 胎儿纤维连接蛋白检测疑似早产课件

《_fibronectin testing for suspected preterm labour in 胎儿纤维连接蛋白检测疑似早产课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、FetalFibronectinTestingforSuspectedPretermLabourAnemergingstandardofcare(Note:Pleasefeelfreetouseyourownbackgrounddesign)FetalFibronectinTestingforSuspectedPretermLabourObjectivesDiscussincidenceofpretermlabourprovinciallyandnationallyDescribethebenefitsoffetalfibronectin

2、testingOutlineinsertprovinceapproachtothisemergingstandardofcareProvidedetailedclinicaldecisionmakingandproceduresforfFNtestingPretermLabour(<37weeks)1in5pregnantwomenexhibitsignsandsymptomsofpretermlabour.3-4%ofbirthsoccurbefore34weeksUpto70%ofwomenidentifiedas“high-risk

3、”deliveratterm.Maximumclinicaljudgmentsensitivityfordel<1weekfromadmissionwas<50%withminimalcervicaldilatation(<3cm.).PretermBirthPretermbirthrateisdefinedasthenumberoflivebirthswithagestationalagelessthan37weekscompletedweeksgestation>7.6%(allProvinces)ofallpregnanciesre

4、sultinpretermbirthSources:ACOGTechnicalBulletin,1995,No.206;NationalVitalStatisticsReport2000;48(3).StJohnEBetal.AmJObstetGynecol.2000;182:170-175.Macones,AmJObGyn,Vol181,12/99RateofPretermDeliverybyProvince/Territory(excludingOntario)2000AddownprovincialdataTheChallenge…

5、Thepretermbirthratehasnotdecreasedinthelastthirtyyears!!!Source:CPSSReport2003p.7420percentincreaseHowdoweidentifywhoisatRisk?RiskFactorsCervicalLengthFetalFibronectinSymptomsofPTLPretermBirthTocolyticsEducationTargetingHighRiskWomenBedrestHomeUterineMonitoringFrequentDig

6、italExamHydrationPopulationBasedstrategiesPrevention/InterventionStrategiesRiskAssessmentMarkersBiophysicalmarkersMeasurementofcervicallengthBiochemicalmarkersFetalfibronectin(fFN)Salivaryestriol(E3)Corticotropin-releasinghormone(CRH)Interleukin-6(IL-6)PotentialBenefitsof

7、AnEvidence-Based,RiskAssessmentMarkerIdentifywomenwhoaretrulyatrisk.Identifyandreassurewomenwhoarenotatrisk.Avoidseparationofmotherfromherfamily.Avoidunnecessaryexpenseofextendedassessmenttime,admissiontime,transporttoatertiarycentre.Avoidunnecessarytocolyticandsterioduse

8、.Improvedresourceutilization.Potentialresearchbenefitse.g.focustocolytictrialsonwomenwhowillpote