重度妊高征患者终止妊娠的时机及方式对母儿的影响

The Effect of Timingand Route of Pregnancy Termination on Maternal and Perinatal Outcome in Pre-eclampsia and Eclampsia

本文根据１９８２年－１９９５年在我院分娩的连续的１００例重度妊高征患者，分析终止妊娠的时机、方式以及对母儿预后的影响。终止妊娠时间在３４孕周前者１３例，３４一３７孕周者１３例，３７孕周后者７４例。其中剖宫产５５例，经阴道分娩４５例。结果产妇完全康复，围产儿死亡率１４．４％，新生儿窒息率２４％。孕周≥３４周者，经阴道分娩与剖宫产母儿预后无明显差异；３４周前终止妊娠者，经阴道分娩新生儿死亡率很高。提示重度妊高征多发生在３７孕周后。除对重度妊高征及时终止妊娠外，对中度而病程进展较快者，宜在３４－３７孕周终止妊娠，以减少对母儿的危害。不足３４周者应行剖宫产：３４周以上者可根据情况选择剖宫产或经阴道分娩。

ne hundred conseecutive patients with pre-eclampsia and eclampsia were enrolled foranalysing the relationship between the timing and route of pregnancy termination and maternaland perinatal outcome. 13 cases of them delivered befroe 34 gestational weeks,13 cases at 34-37weeks,74 cases after 37 weeks. 55 cases of them were delivered by cesarean section,45 deliveredvaginally. There was no maternal death Perinatal mortality rate was 14.4%,Neonatal asphyxiarate was 24 %,After 34 weeks. there was no obvious difference in matemal and perinatal prognosisbetween vaginal delivery and cesarean section. Before 34 weeks,the neonatal mortality rate ofvaginal delivery was very high.This analysis suggests that most of the pre-eclampsia and eclampsiaoccured after 37 gestational weeks.Besides those patients with pre-eclampsia and eclampsia needto be delivered promptly,inthe patinents wit h non-severe preganacy-induced hypertention,pregnancy should be terminated at 34-37 gestational weeks if the disease develops rapidly,so thatto reduce the harm to the woman and fetus. Before 34 gestational week,cesarean delivery shouldbe adopted,and after 34 week,cesarean section or vaginal delivery can be selected according to theconditions of the woman and fetus.