重度子前期经阴道分娩58例临床分析

Vaginal delivery in Heavy degree Preeclampsia:Clinical Analysis of 58 Cases

目的：对重度子痫前期经阴道分娩58例临床资料进行分析，探讨经阴道分娩的指征及处理方法，改善母婴预后。方法：回顾性分析我院1993年1月～2004年11月重度子痈前期经阴道分娩58例临床资料。结果：新生几轻度窒息15．38％，重度窒息7．69％，无新生儿死亡；发生产后出血7例，胎盘早剥5例，产前子痈2例，产时子痈、产后子痈、心功能衰竭各1例，母亲全部存活。结论：治疗重度子痈前期，适时终止妊娠是极为重要的手段。选择最佳终止妊娠方式，对改善母婴预后有非常重要的意义。剖宫产无疑是抢救重度子痫前期患者的有效手段之一，但是随着剖宫产率的上升，其并发症较阴道分娩多。因而，对重度子痫前期患者，如病情稳定，具备经阴道分娩条件，在对孕产妇及胎儿进行严密监护下，仍应采取阴道分娩。

Objective:To explore the indications and management of vaginal delivery in pre-eclampsia of severe type by clinically analyzing vaginal delivery in 58 cases of severe type preeclampsia in order to improve the outcome of mothers and infants.Methods:A retrospective analysis was performed over clinical data on 58 cases of vaginal delivery in pre-eclampsia of severe type hospitalized from January in the year 1993 to November,2004.Results:16.66% of the newborn were having light asphyxia while 7.69% were getting heavy asphyxia;no death happened;2 cases of prenatal eclampsia were found;1 case of delivery eclampsia;1 case of postnatal eclampsia;5 cases of placental abruption;1 case of cardiac insufficiency;7 cases postpartum hemorrhage.All of the mothers were survived.Conclusions:For pre-eclampsia of severe type,it is an extremely important means of treatment to terminate the gestation at right time.The choice of the best way to terminate the gestation is very significant to improving the outcome of mothers and infants.Caesarean section is considered one of the most effective methods.But as caesarean rate gets increased,its complications grow as well when compared with vaginal delivery.For this reason,for pre-eclampsia of severe type,vaginal delivery is recommended under the monitoring if patient's condition were stable and the conditions for vaginal delivery could be satisfied.