重度子痫前期终止妊娠时机及妊娠结局分析

Time and method of pregnancy termination in severe preeclampsia and the maternal-perinatal outcome

目的分析重度子痫前期的并发症及其妊娠结局,寻求终止妊娠最佳时机和方式。方法对203例孕23＋3-39＋3周重度子痫前期患者临床资料进行回顾性分析,比较不同孕周终止妊娠者分娩方式及母婴预后的差异。结果重度子痫前期并发低蛋白血症69例,并发心衰4例,胎盘早剥15例,胎儿宫内发育迟缓19例,产后出血42例,溶血、肝酶升高、低血小板综合征（HELLP）3例;孕34-36周分娩组剖宫产率最高,与其他两组比较差异有显著性意义（P〈0.05）;新生儿窒息率和围生儿死亡率在孕28-33周组最高,孕34-36周组和≥37孕周组比较差异无显著性意义（P〉0.05）。结论重度子痫前期并发症随着孕周增加而增多,适时终止妊娠可减少母婴并发症,降低围产儿死亡。

Objective To study the relationship between the time and method of pregnancy termination and the maternal-perinatal outcome in pregnant women with severe preeclampsia.Methods A retrospective analysis was undertaken on 203 cases of severe preeclampsia patient pregnancing between 23＋3-39＋3 weeks.Results There were totally 69 pacients who suffered from hypoproteinemia,4 heart failure,15 placental abruption,19 fetal growth restriction,42 postpartum hemorrhage and 3 HELLP syndrome.The cesarean section rate was the highest in 34～36 pregnancy week group.The Neonatal asphyxia rate and perinatal mortality was highest in 28～33 week group,and there was no significant difference in the rest two groups.The incidence of placental abruption and fetal distress was lower in 〈 37 week group than that in ≥ 37 week group.The incidence of eclampsia was lower in cesarean group than that in vaginal delivery group.Conclusion In severe preeclampsia,pregnancy should be terminated intime.Termination of pregnancy is one of the most important treatment methods,and cesarean section is the first choice.