80例重度子痫前期的临床特点和妊娠结局分析

Clinical features and maternal and neonatal outcomes of severe preeclampsia

目的:探讨早发型及晚发型重度子痫前期的临床特点及围产结局。方法:回顾性分析东南大学附属江阴医院产科2010年1月至2012年2月收治的重度子痫前期80例患者的临床资料,将其分为早发型重度子痫前期组(早发型组,妊娠<34周,20例)和晚发型重度子痫前期组(晚发型组,妊娠≥34周,60例)。结果:孕产妇并发症早发型组高于晚发型组,终止妊娠的孕周早于晚发型组,终止妊娠的方式剖宫产率高于晚发型组,差异均具有统计学意义(P<0.05);胎儿窘迫、死胎、胎儿生长受限、新生儿窒息、新生儿死亡等发生率早发型组显著高于晚发型组(P<0.01)。结论:早发型重度子痫前期严重影响母婴预后,适当期限的期待治疗有助于改善母婴结局,剖宫产是终止重度子痫前期的主要方法。

Objective： To explore clinical features and maternal and neonatal outcomes of early and late onset severe preeclampsia. Methods： Clinical data of 80 cases of severe preeclampsia in Southeast University Jiangyin Hospital from January 2010 to February 2012, were collected and then analyzed. The patients were divided into two groups ,20 cases of early onset severe preeclampsia group（ onset gestational weeks 〈 34）and 60 cases of later onset severe preeclampsia group （onset gestational weeks I〉34）. Results： The rates of complications of early onset severe preeclampsia group were higher than that of later onset severe preeclampsia group , and the rate of cesarean section in early onset severe preeclampsia group were higher than that of later onset severe preeclampsia group with an obvious differences （ all P 〈 0. 05 ）. Significant difference of two groups were found in the rate of fetal distress, dead fetus in uterus, FGR, neonatal asphyxia and neonatal death（P 〈0. 01 ）. Conclusions： Clinical symptoms of early onset severe preeclampsia are more serious, and have a higher incidence of abnormal maternal and neonatal outcomes. The suitable duration of expectant management can improve maternal-prenatal prognosis. Cesareansection is the major method of terminating severe preeclampsia.