重度子痫前期及子痫围生儿预后分析

Analysis of perinatal prognosis of severe pre-eclampsia and eclampsia

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月收住我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,比较疾病的严重程度、孕周及分娩方式对围生儿预后的影响。结果:重度子痫前期及子痫患者的围生儿死亡率随孕妇病情加重而升高;随孕周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率最低,剖宫产新生儿缺氧缺血性脑病、窒息及围生儿死亡率较阴道分娩低。结论:围生儿病率及死亡率与重度子痫前期及子痫的发病时间和严重程度密切相关,适时终止妊娠可提高围生儿成活率,必要时可提前至34孕周终止妊娠,剖宫产是治疗重度子痫前期及子痫的有效措施。

Objective： To understand effect of severe pre - eclampsia and eclampsia on perineonates, and to discuss the appropri- ate delivery time and method in patients with pre -eelampsia and eclampsia, in order to reduce perinatatal morbidity and mortality. Methods： Patients with pre - eclampsia and eclampsia in this hospital from 2003 Jan to 2005 Dec were enrolled, the clinical data were reviewed to compare the severity of disease, gestational weeks and delivery method with perinatal prognosis. Results： With the increasing of the sererity of disease, the perinatal mortality and morbidity increased gradually; and with the increasing of embryo age, the perinatal mortality and morbidity decreased gradually. Among them, it was lowest at thirty -six gestational weeks. There was lower incidence of neonatal hypoxic ischemic encephalopathy, asphyxia and lower perinatal morbidility and mortality in cesarean section than those in vaginal delivery. Conclusion ： The perinatal mortality and morbidity is closely related to attack time and the severity of pre - eclampsia and eclampsia. Timely termination of pregnancy can increase the survival rate of perineunate. If necessary, it is can be terminated at 34 gestational weeks; Cesarean section is an effective mean to terminate pregnancy with severe pre - eclampsia and eclampsia.