影响早发型重度子痫前期期待治疗结局的因素及临床分析

Effect factors and clinical analysis on expectant treatment outcomes of early onset severe preeclampsia

目的:探讨影响早发型重度子痫前期期待治疗妊娠结局的因素和临床意义。方法:对2005年1月～2010年2月收治的78例经期待治疗的早发型重度子痫前期孕妇的临床资料进行分析,并根据其发病孕周分为3组。Ⅰ组孕24～27+6周,Ⅱ组孕28～31+6周,Ⅲ组孕32～34+6周;比较3组患者和围产儿并发症的情况。结果:早发型重度子痫前期患者78例,前期期待治疗后18例(23.1%)孕妇出现严重并发症,无孕产妇死亡。胎死宫内4例,4例新生儿死亡,围产儿死亡率为10.3%。结论:早发型重度子痫前期母婴预后受到发病孕周及终止妊娠孕周的影响,应严格选择病例根据病情进行期待治疗,治疗过程中严密监测母胎情况,选择适合的时机和方式终止妊娠,以减少母婴不良妊娠结局。

Objective：To explore the effect factors of expectant treatment outcomes of early onset severe preeclampsia and clinical significance.Methods：The clinical data of 78 pregnant women with early onset severe preeclampsia receiving expectant treatment from January 2005 to February 2010 were analyzed retrospectively,then the pregnant women were divided into three groups according to pathogenic gestational weeks： group I（24～27＋6 gestational weeks）,group II（28～31＋6 gestational weeks） and group III（32～34＋6 gestational weeks）;the complications of pregnant women and perinatal infants in the three groups were compared.Results：Among 78 pregnant women with early onset severe preeclampsia,18 pregnant women（23.1%） developed severe complications after expectant treatment,no pregnant women died;fetal intrauterine death occurred in 4 pregnant women,neonatal death occurred in 4 cases,the perinatal mortality was 10.3%.Conclusion：The prognosis of mothers and infants in cases with early onset severe preeclampsia is affected by pathogenic gestational weeks and termination weeks of pregnancy,the cases receiving expectant treatment should be selected strictly,and the status of mothers and fetuses should be monitored closely in the course of treatment,choosing appropriate opportunity and way to terminate pregnancy may decrease adverse pregnancy outcomes of mothers and fetuses.