早发型重度子痫前期的临床特点及围生期结局

Clinical characteristics and perinatal outcomes of early onset severe preeclampsia

目的探讨早发型重度子痫前期患者的临床特点及对母婴预后的影响。方法选取2001年1月～2004年12月天津市中心妇产科医院住院的794例重度子痫前期患者作为研究对象,将病例分为早发型重度子痫前期(妊娠<32周,312例)和晚发型重度子痫前期(妊娠≥32周,482例)。回顾性分析比较两组患者的临床资料。结果早发型重度子痫前期组临床严重并发症如子痫、心衰、肺水肿、腹水、胸腔积液、胎盘早剥、产后出血的发生率均明显高于晚发型重度子痫前期组,差异有显著性(P<0.01);早发型重度子痫前期组围产儿死亡率及新生儿Apgar评分≤7分的发生率显著高于晚发型重度子痫前期组(P<0.01)。结论早发型重度子痫前期病情严重,围产儿预后不良,应根据母婴情况,严格选择病例进行期待疗法,同时密切监测母婴病情变化。

Objective To investigate the clinical characteristics and perinatal outcomes of early onset severe preeclampsia. Methods The clinic records of 794 severe preeclampsia cases in Tianjin Central Hospital of Obstetric and Gynecology were reviewed from January 2001 to December 2004. Grouping by the onset of preeclampsia before or after 32 weeks of gestation, the clinical features and perinatal outcomes were compared between early onset preeclampsia （n：312） and late onset group （n=482）. Results The incidences of convulsion, heart failure, pulmonary edema, pleurale effusion, ascites, placenta abruption, postpartum hemorrhage were significantly higher in early onset preeclampsia group than in late onset group （P〈0. 01）. Neonates with 5 min Apgar score ≥7 and neonates morbidity were significantly more in the early onset preeclampsia group than in the late onset group （P〈0.01）. The incidences of preexisted chronic hypertension and chronic renal diseases were also significantly higher in early onset preeclampsia group than in the late onset group. Conclusions Early onset severe preeclampsia is prone to present severe complications. The outcomes of mother and infant can be poor. Obstetricians should select cases carefully for expectant treatment and close monitoring is very important for those mothers and infants.