重度妊娠高血压综合征剖宫产有关问题的探讨

Inqiure into the Relationship Between Caesarean Section and Severe Pregnancy-induced Hypertension

收治重度妊娠高血压综合征（简称妊高征）１１６例，其中８８例行剖宫产术，剖宫产率７６．５２％，剖宫产的第一指征前４位顺序为：重度妊高征５７例，头盆不称８例，胎儿宫内窘迫６例，宫颈扩张活跃期停滞４例。本组病例产褥病率１４例占１５．９％。产后出血７例占８％。并发ＨＥＬＬＰ综合征２例，其中１例母亲死亡。非剖宫产直接原因围产儿死亡２例。分析了重度妊高征剖宫产率上升的趋势和原因，认为重度妊高征剖宫产可降低母婴死亡率。结合病例分析了重度妊高征剖宫产指征。

One hundred and sixteen pregnant women complicated severe pregnancy induced hypertension(PIH)were admitted in our hospital through Jan,1991 to Aug,1993.88 of patients had caesarean section,the rate was 76.52% (88/116).The first four indications were severe pregnancy induced hypertension, CDP,intrauterine fetal distress and prolonged labour in succession.The purperal morbidity was 15. 9%(14/88).The incidence of postpartum hemorrhage was 8% (7/88) and two patients developed HELLP syndrom resulting in one maternal death.There were two cases of perinatal mortality associating with non-operation causes.In this paper, the causes,increasing tendency of caesarean section rate,also the indications of caesarean section in severe PIH were discussed.The conclusion is:appropriately choicing caesarean section indications may have some advantages in decrease maternal and perinatal mortality.