早发与晚发型重度子痫前期对围产儿结局影响

Impacts of early onset and late onset severe preeclampsia on perinatal outcome

目的探讨早发型重度子痫前期与晚发型重度子痫前期对围产儿的影响。方法选择2008年10月。2009年10月在甘肃省妇幼保健院治疗的早发型重度子痫前期孕妇32例，随访其围产儿的，临床结局和预后，与同期随机选取的45例晚发型重度子痫前期孕妇的围产儿结局进行比较。结果早发型重度子痫前期组的剖宫产率、羊水污染率、新生儿窒息率、围产儿死亡率与晚发型重度子痫前期组比较，差异均有统计学意（X^2分别为8。342、6．301、9．692、12．485，均P〈0．05）；早发型重度子痫前期组的分娩孕周和出生体重与晚发型重度子痫前期组比较，差异亦均有统计学意义（t分别为－3．559、－7．077，均P〈0．05）。结论对于重度子痫前期孕妇，发病孕周越小，胎儿窘迫、新生儿窒息、围产儿死亡、早产的发生率越高。因此在保证母亲安全的前提下，尽量延长孕周，可显著改善围产儿不良结局，提高新生儿的生存率。

Objective To investigate impacts of early onset severe preeclampsia （EOSP） and late onset sever preeclampsia （LOSP） on maternal and neonatal outcomes. Methods 32 pregnant women with EOSP who were treated in our hospital in a period from October, 2008 to October, 2009 were clinically followed-up for their perinatal outcome and prognosis. 45 pregnant women with LOSP were selected randomly in the same period. The perinatal outcomes of pregnant women in the two groups were compared. Results As compared with LOSP group, rates of cesarean section, amniotic fluid contamination, neonatal asphyxia and neonatal mortality in EOSP group were significantly higher （X^2 = 8. 342, 6. 301, 9. 692, 12. 485 respectively, all P 〈 0.05 ）. And incidence rates of gestational age at delivery and low birth weight infants in EOSP group were significantly higher than those in LOSP group （ t = - 3. 559, - 7. 077 respectively, both P 〈 0.05 ）. Condusion For SP pregnant women, the smaller the gestational age, the higher the incidence rates of fetal distress, neonatal asphyxia, perineonatal mortality and premature delivery. Under promise of ensuring mother＇ s safety, prolonging the gestational age as possible can greatly improve periprenatal outcome and neonatal survival rate.