早发型重度子痫前期终止妊娠时机及分娩方式与围生儿结局的关系研究

Study on the relationship of the timing of pregnancy termination and delivery methods of early onset severe preeclampsia and the outcome of perinatal

目的：探讨早发型重度子痫前期终止妊娠时机及分娩方式与围生儿结局的关系。方法：选取我院2006年9月-2010年9月收治的早发型重度子痫前期患者（除外其他妊娠合并症及并发症）220例为研究对象，该组患者的发病孕周均≤34周，按照分娩方式的不同分为阴道分娩组和剖宫产组，按照终止妊娠时间的不同分为28～30周组，31～32周组，33—34周组，〉34周组，比较各组围生儿结局及孕产妇并发症发生率。结果：早发型重度子病前期终止妊娠时间的不同患者之间，其并发症的发生率比较，差异无统计学意义（P〉0．05）。但随着终止妊娠时间的延长，新生儿的成活率均呈现显著下降，各组之间比较，差异有统计学意义（P〈0．05）。剖宫产组的新生儿成活率显著高于阴道分娩组，两组比较，差异有统计学意义（P〈0．05）。结论：≤34孕周的患者，随着终止妊娠孕周增加，新生儿成活率增加，故≤34孕周的患者适当延长孕周．且合理采用剖宫产能有效降低新生儿窒息发生率及围生儿死亡率。

Objective： To investigate the relationship of timing of pregnancy termination and delivery methods of early onset severe preeclampsia to perinatal outcome. Methods： 220 patients in early onset severe preeclampsia （besides other pregnancy comorbidities and complications） treated in our hospital from September 2006 to September 2010 were selected. The gestational weeks of illness onset of this group of patients were all ≤34 weeks. This group of patients was divided into the vaginal delivery group and the cesarean section group by delivery method and the 28-30 weeks group, the 31-32 weeks group, the 33-34 weeks group and the 〉34 weeks group by time of pregnancy termination. Perinatal outcomes and incidences of maternal complications of the two groups were compared. Results： Between patients in early severe preeelampsia with different times of pregnancy termination, the incidences of maternal complications had no significant dif- ferences （P〉0.05）. But as the time of pregnancy termination prolonged, the neonate survival rates reduced significantly, with statistically significant differences between groups （P〈0.05）. The neonate survival rate of the cesarean section group was significantly higher than that of the vaginal delivery group （P〈0.05）. Conclusion： For patients with the gestational week of ≤34 weeks, as the gestational week of pregnancy termination increases, the neonate survival rate increases. As a result, appropriate prolongation of the gestational week and reasonable application of cesarean section in patients with the gestational week of ≤34 weeks can effectively reduce the neonatal asphyxia incidence and the perinatal mortality.