重度妊高征147例终止妊娠时间及方式的探讨

Discussion on the delivery time and route for women with severe pregnancy-induced hypertension.

目的:通过对147例重度妊高征围生儿进行的结局分析,探讨重度妊高征终止妊娠的最佳时间和方式。方法:1998-2004年共接收孕产妇6096例,其中妊高征421例,重度妊高征147例。对147例重度妊高征围生儿的资料进行了分析。结果:胎龄达36孕周的围生儿无1例死亡及重度窒息,仅3例有青紫窒息,预后好。孕36周组新生儿窒息及围生儿病死率均低于<36周组和≥37周组。以重度妊高征为剖宫产指征者66例(44．89％)。剖宫产组新生儿窒息和围生儿病死率明显低于阴道分娩组,对产前子痫患者用药物控制抽搐后行剖宫产结束分娩,以防止再抽搐。结论:重度妊高征达36周对胎儿影响最小,应考虑终止妊娠,以免病情加重;剖宫产是重度妊高征患者终止妊娠的主要措施之一。

Objective： To explore the most suitable delivery time and the best route to terminate pregnancy for women with severe pregnancyinduced hypertension by analyzing the perinatal outcome. Methods： Analyzed the data of perinatal from 147 women with severe pregnancy induced hypertension in our hospital from 1998 to 2004. Results： No death and severe asphyxia happened in perinatal with gestational age of 36 weeks. Three perinatal with cyanotic asphyxia had good outcomes. The neonatal asphyxia and perinatal mortality in gestational age of 36 weeks were lower than that in gestational age below 36 weeks and over 37 weeks. Cesarean section was performed due to severe pregnancy-induced hypertension in 66 patients（44.98%）. The neonatal asphyxia and perinatal mortality in cesarean section group were significant lower than that in vaginal delivery group. Patients with eclampsia were terminated pregnancy with cesarean section after controlled seizure with medicaments. Conclusions： The gestational age of 36 weeks was the best time to terminate pregnancy for patients with severe pregnancy induced hypertension due to the minimum impact to fetal. And cesarean section was the main delivery route for patients with severe pregnancy-induced hypertension.