早发型重度子痫前期终止妊娠的临床探讨

Clinical study on the termination of pregnancy in pregnant women with early onset severe pre-eclampsia

目的探讨早发型重度子痫前期的终止妊娠时机、方式及预后。方法328例重度子痫前期和子痫患者按发病孕周分为早发型(34周前发病)112例与晚发型(34周后发病)216例,分析比较其终止妊娠的时机、方式、围产儿结局、产妇并发症情况。结果早发型子痫前期孕妇大多在治疗效果不佳的情况下及时终止妊娠,以阴道分娩为主,剖宫产率(29.46%)明显低于晚发型(70.37%),围产儿病死率(34.82%)明显高于晚发型(5.09%);112例早发型孕妇中发生并发症32例(28.57%),216例晚发型孕妇中发生并发症61例(28.24%),二者比较差异无显著意义(P>0.05)。由于适时终止妊娠,无产妇死亡。结论及时终止妊娠是早发型子痫前期重要的处理方法,可以有效地避免产妇严重的并发症,对于估计胎儿存活可能性小的,应以阴道分娩为主,以减少剖宫产对母体的创伤。

Objective To investigate the effect of timing of pregnancy termination on maternal and fetal outcomes in early onset severe pre-eclampsia.Methods 328 patients with severe pre-eclampsia were divided into early onset group （≤34 weeks, n = 112） and late onset group （ 〉 34 weeks, n =216） .The time and type of termination of pregnancy, outcome of perinatal baby and the complications of parturients were compared and analyzed between the two groups.Results The termination of pregnancy was performed in the pregnant women whose therapeutic effects were worse, and vaginal delivery was major delivery type for these women. The rate （29.46%） of cesarean section in early onset group was significantly lower than that （70.37 % ） of late onset group. The death rate （34.82 % ） of perinatal baby in early onset group was significantly higher than that （5.09 % ） of late onset group. The incidence of complications in early onset group was 28.57% （32 cases） ,which was 28.24% （61 cases） in late onset group.There was no significant difference between the two groups （ P 〉 0.05）. There was no death of pregnant women because of timely termination of pregnancy. Conclusion Timely termination of pregnancy is an important method for pregnant women with early onset severe pre-eclampsia, which could reduce severe complications, and vaginal delivery should be an important type for less impossible survival neonates so as to reduce the effect of injury caused by cesarean section on parturients.