早发型重度子痫前期79例临床分析

Clinical analysis in 79 cases of early onset severe preeclampsia

目的探讨早发型重度子痫前期的治疗及对母儿的影响。方法回顾性分析本院79例早发型重度子痫前期患者的有关临床资料,按发病孕周将其分成三组即A组(孕周<28周)12例、B组(28周≤孕周<32周)35例和C组(32周≤孕周<34周)32例,分析各组孕期治疗期限、孕妇并发症、胎儿和新生儿结局。结果三组保守治疗时间比较,A组与B组、C组与B组之间差异有统计学意义(P<0.05),其中B组延长孕龄最长;三组孕妇并发症发生率随发病孕周延长而下降,但三组间比较无显著性差异(P>0.05);胎儿及新生儿死亡率比较,C组明显低于A、B组(P<0.01),B组低于A组(P<0.05)。结论早发型重度子痫前期严重影响母儿健康,保守治疗可行,但要严密监测母儿情况,适时终止妊娠,终止妊娠的方式首选剖宫产。

Objective：To study expectant management and the impact on the maternal and neonatal outcome in early onset severe preeclampsia.Methods：A retrospective study was carried out on 87 patients.Methods：A retrospective study was carried out on 87 patients with early onset severe preeclampsia.Patients were divided into group A（n=12）withonset before 28 weeks of gestation,group B（n=35）with onset during 28~31＋6weeks of gestation,group C（n=32）with onset during 32~33＋6gestational weeks according to hospitalized week of gestation.The clinical data were evaluated.Analytic index included prolongation of gestations and maternal outcomes and prenatal mortality and morbidities.Results：The average pregnancy prolongations of group B was longer than that of in the groups A and C（P〈0.05）.The fatal and new born death of group C was lower than that of in the groups A and B（P〈0.01）and that of groups B was lower than that of in the groups A （P〈0.05）.Conclusion：It is feasible for expectant managrment of early onset of severe preeclasmpsia under intensive care and appropriarely selected cases.The perinatal outcome is associated with the onset time of severe preeclampsia.The cesarean is the first selection in the end of pregnancy