| Autor: |
Sciscent, Bao Y., Bhanja, Debarati, Daggubati, Lekhaj C., Ryan, Casey, Hallan, David R., Rizk, Elias B. |
| Předmět: |
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| Zdroj: |
Child's Nervous System; Mar2023, Vol. 39 Issue 3, p625-632, 8p |
| Abstrakt: |
Purpose: Spina bifida (SB) is caused by a failure in neural tube closure that can present with lower extremity sensory deficits, paralysis, and hydrocephalus. Medical advances have allowed increased pregnancies among SB patients, but management and pregnancy-associated complications have not been thoroughly investigated. The objective is to delineate peripartum procedures and complications in patients with SB. Methods: A national de-identified database, TriNetX, was retrospectively queried to evaluate pregnant SB patients and the general population. Procedures and complications were investigated using corresponding ICD-10 and CPT codes within 1 year of pregnancy diagnosis. Results: 11,405 SB patients were identified and compared to 9,269,084 non-SB patients. SB patients were significantly more likely to undergo cesarean delivery (1.200; 95% CI [1.133–1.271]) and less likely to receive neuraxial analgesia (0.406; 95% CI [0.383–0.431]). Additionally, patients with SB had an increased risk of seizures (3.922; 95% CI [3.529–4.360]) and venous thromboembolism (VTE) (3.490; 95% CI [3.070–3.969]). Risks of preeclampsia and hemorrhage were comparable. SB patients with hydrocephalus and Chiari malformation type 1 (CM-1) or type 2 (CM-2) were compared to patients without these comorbid conditions. This sub-group analysis showed a significantly increased risk of having cesarean deliveries (SB with hydrocephalus: 12.55%, S.B. with CM-1 or CM-2: 12.81% vs. SB without hydrocephalus or CM, 6.16%) and VTE (3.74%, 2.43% vs. 0.81%). There were also increased risks of hemorrhage and seizures and decreased use of neuraxial analgesia, but the sample size was insufficient. Conclusion: SB patients were more likely to undergo cesarean section and exhibit peripartum complications compared to those without SB. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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