目的:开发基于证据的常见产时尿路异常处理的临床算法。
方法:单身女性,积极分娩和产后即刻的足月妊娠,低并发症风险。
方法:低收入和中等收入国家的医疗设施。
方法:对世卫组织现行指南进行了系统的检索和综述,Nice,ACOG和RCOG。截至2020年5月,在PubMed和Cochrane系统评论数据库上进行了额外的搜索。
UNASSIGNED:选择了四种常见的产时尿异常:蛋白尿,酮尿症,糖尿和少尿。使用试剂条测试,糖尿定义为一次≥2+或两次或两次以上≥1+。蛋白尿定义为≥2+,酮的存在表明酮尿。少尿定义为每小时尿量≤30ml。使用历史记录进行彻底的初步评估,体检和基本调查有助于区分大多数根本原因,其中包括糖尿病,脱水,脓毒症,先兆子痫,震惊,贫血,阻碍劳动,潜在的心脏或肾脏问题。针对每种尿液异常开发了一种临床算法,以促进产时管理和复杂病例的转诊以进行专门护理。
结论:四个简单的,我们开发了用户友好和循证的临床算法,以加强对产妇常见尿液异常的产时护理.这些算法可用于在处理正常和潜在复杂的分娩时支持医疗保健专业人员进行临床决策。特别是在资源匮乏的国家。
结论:开发了基于证据的临床算法来指导常见的泌尿异常的产时管理。
OBJECTIVE: To develop evidence-based clinical algorithms for management of common intrapartum urinary abnormalities.
METHODS: Women with singleton, term pregnancies in active labour and immediate postnatal period, at low risk of complications.
METHODS: Healthcare facilities in low- and middle-income countries.
METHODS: A systematic search and review were conducted on the current guidelines from WHO, NICE, ACOG and RCOG. Additional search was done on PubMed and The Cochrane Database of Systematic Reviews up to May 2020.
UNASSIGNED: Four common intrapartum urinary abnormalities were selected: proteinuria,
ketonuria, glycosuria and oliguria. Using reagent strip testing, glycosuria was defined as ≥2+ on one occasion or of ≥1+ on two or more occasions. Proteinuria was defined as ≥2+ and presence of ketone indicated
ketonuria. Oliguria was defined as hourly urine output ≤30 ml. Thorough initial assessment using history, physical examination and basic investigations helped differentiate most of the underlying causes, which include diabetes mellitus, dehydration, sepsis, pre-eclampsia, shock, anaemia, obstructed labour, underlying cardiac or renal problems. A clinical algorithm was developed for each urinary abnormality to facilitate intrapartum management and referral of complicated cases for specialised care.
CONCLUSIONS: Four simple, user-friendly and evidence-based clinical algorithms were developed to enhance intrapartum care of commonly encountered maternal urine abnormalities. These algorithms may be used to support healthcare professionals in clinical decision-making when handling normal and potentially complicated labour, especially in low resource countries.
CONCLUSIONS: Evidence-based clinical algorithms developed to guide intrapartum management of commonly encountered urinary abnormalities.