重度子痫前期及子痫终止妊娠时机及方式的选择

Effective approachon terminating pregnancy with severe pre-esclampia and esclampsia

目的了解重度子痫前期及子痫对围生儿的影响，探讨终止妊娠时机及方式，降低围生儿的发病率及死亡率。方法对2003年1月～2005年12月收住本院产科的重度子痫前期及子痫患者的临床资料进行回顾性分析，观察围生儿病率及围生儿死亡率，比较孕周、分娩方对围生儿预后的影响。结果随胎龄增加围生儿病率及死亡率逐渐降低，其中36周围生儿病率及死亡最低，剖宫产新生儿病率及围生儿死亡率较阴道分娩低。结论重度子痫前期及子痫36～36^＋6孕周终止妊娠对围生儿影响最小，预后最好；从胎肺成熟必要时可提前至35周终止妊娠；剖宫产是重度子痫前期及子痫终止及子痫终止妊娠的有效方法。

Objecive To understand effect of severe pre- esclampsia and esclampsia on perineonates, and discuss the appropriate delivery time and method in patients with pre - esclampsia and esclampsia in order to reduce perinattal morbidity and mortality. Methods Patients with pre - eclampsia and eclampsia in our hospital from Jan. 2003 to Dec. 2005 were enrolled, the clinical datas were restrospected to observe perinatal morbidility and mortality and impact of gestational weeks and delivery method with perinatal prognosis. Results The perinatal mortality and morbidity decreased gradually, along with the increasing of embryoage. Among them, it was lowest at thirty - seven gestational weeks. There was lower perinatal morbidility and mortality in cesarean section than in vagi- nal delivery. Conclusions ： It is the lest effect on perineonate and the best prognosis when pregnancy with pre - eclampsia and eclampsia are terminated at 36 - 36^＋6 gestational weeks; Fetal lung maturity pregnancy can be terminated at 35 gestational weeks; Cesarean section is an effective way to terminate pregnancy with severe pre -esclampsia and esclampsia.