早发型重度子痫前期期待治疗妊娠结局分析

Analysis on outcome of pregnancy after expectant management of early onset severe pre-eclampsia

目的探讨早发型重度子痫前期及期待治疗对妊娠结局的影响。方法对2005年1月至2009年5月于我院住院分娩、孕周<34周早发型重度子痫前期患者64例随机分为分期待治疗组28例(研究组)和非期待治疗组36例(对照组),评价各组的妊娠结局,包括新生儿出生体质量,围生儿病死率和患者产后3d24h尿蛋白定量。结果研究组28例,新生儿(早产儿)平均出生体质量(1870±430)g;对照组36例,早产儿平均出生体质量(1650±310);研究组围生儿病死率5/28,对照组15/36。两组比较均有显著差异(P<0.05)。研究组患者产后3d24h尿蛋白定量平均(1030±630)g/24h;对照组患者产后3d24h尿蛋白定量平均(990±540)g/24h,两组比较无显著差异(P>0.05)。结论对早发型重度子痫前期进行有效的保守治疗,能明显增加新生儿出生体质量,提高新生儿的生存率,且并不增加产妇并发症和产后恢复的时间。

Objective To study the impact of expectant management on early onset severe pre -eelampsia in maternal and neonatal outcome. Methods Clinical data of 64 patients with early onset severe pre - eelampsia （ onset during 28 to 34 gestational weeks） treated in this hospital during January, 2005 to May, 2009 were retrospectively analyzed, 28 cases （ trial group） received expectant management, and the remaining 36 eases （ control group） received nonconservative therapy. The general condition of mother, complications and outcomes of both mother and infants were surveyed. Results The average birth weight of neonates in trial group [ （ 1 870 ± 310） g ] was significantly higher than that of control group [ （ 1 650± 430）g ]. The perinatal and neonatal mortality rates were significantly lower in trial group （5/28） than in control group （15/36）. There was no sig- nlficant difference in amount of 24 -hour urinary protein between these two groups in 3 days after delivery [ （1030 ± 540）mg/24h vs （990 ± 630） mg/24h ]. Conclusion Expectant management of early onset severe pre - eclampsia is safe and it may enhance birth weight of neonates and reduce perinatal mortality, but it has no significant influence on the occurrence of maternal complications and time for recovery .