重度子痫前期及子痫的干预及治疗对策

The treatment and preventive strategy of the severe pre-eclampsia/ecampsias

目的:探讨重度子痫前期及子痫对妊娠结局的影响及干预措施。方法:研究分析重度子痫前期及子痫284例,并对母婴的妊娠结局与同期正常住院分娩的284例作对照。结果:重度子痫前期及子痫发生率为2.49%,其剖宫产、产后出血、胎盘早剥、合并心衰、低出生体重儿、新生儿窒息、围生儿死亡率等均高于对照组,P<0.01,差异有统计学意义;<34周重度子痫前期围生儿死亡率高达52.46%,34周以后围生儿死亡率明显降低,为3.62%,差异有统计学意义;且系统产前检查可降低重度子痫前期及子痫的发生率。结论:重度子痫前期及子痫严重危害母婴健康,系统管理对预防、降低重度子痫前期及子痫的发生起着重要的作用;重度子痫前期在保证母亲安全前提下,积极的期待治疗至34周后终止妊娠结局较好。

Objective： To investigate the influence of the severe pre-eclampsia/ecampsias on pregnancy and the countermeasures. Methods： A study was done on 284 cases severe pre-eclampsia/ ecampsias and compared to the same period pregnancy. Results： The incidence rate of severe pre- eclampsia/ecampsias was 2.49%. Among them, the cesarean section, postpartum hemorrhage, placental abruption, heart failure,low birth weight infants, neonatal asphyxia and perinatal mortality were higher than that of the control group （P 〈 0.01 ）. For the gestational weeks 〈 34, the perinatal mortality of severe pre-eclampsias was 52.46%. For the gestational weeks 〉 34,it was obviously lower （3.62%）. Antenatal care can reduce the incidence rate of the severe pre-eclampsia/ ecampsias. Conclusion： The severe pre-eclampsia/ecampsias is harmful to both maternal and in- fants health . The Antenatal care plays a positive role to prevent and reduce the incidence of severe the pre-eclampsia/ecampsias . Under the precondition of ensuring the maternal safety,it is better outcome to adopt the expectant treatment and terminate pregnancy until 34（th） week.