重度子痫前期及子痫终止妊娠时机和方式的选择

Pregnancy Termination Timing and Treatment Options of Severe Preeclampsia and Eclampsia

目的探讨重度子痫前期及子痫终止妊娠时机和方式,以减少围生儿的发病率和病死率。方法回顾性分析2009年1月至2012年12月新疆喀什地区第二人民医院治疗的79例重度子痫前期及子痫患者的临床资料,对两组患者产时子痫、产后出血、产褥感染情况,以及新生儿死亡、窒息情况进行综合观察与比较。结果孕周<34周的产妇新生儿死亡数、新生儿窒息数和呼吸窘迫综合征(RDS)、缺氧缺血性脑病(HIE)、胎儿生长受限(FGR)的发生率最高,与其他孕周比较差异有统计学意义(P<0.05);剖宫产引起的新生儿死亡、窒息、RDS、HIE以及引起产妇的子痫、产后出血、产褥感染等的发生率较阴道分娩低(P<0.05)。结论重度子痫前期及子痫适时终止妊娠可提高围生儿生存率,其中孕36周终止妊娠对围生儿影响最低,剖宫产是重度子痫前期及子痫终止妊娠的有效措施。

Objective To study the pregnancy termination timing and treatment of severe preeclampsia and eclampsia,in order to reduce the perinatal morbidity and mortality. Methods A retrospective analysis on the clinical data of 79 patients with severe preeclampsia and eclampsia from Second People＇s Hospital in Xinjiang of Kashi Region during January 2009 and December 2012 was done, the eciampsia intrapartum, postpartum hemorrhage, puerperal infection, neonatal mortality and asphyxia of the two groups were compre- hensively observed and compared. Results newborn asphyxia, newborn mortality and the incidence of RDS, HIE, FGR of puerpera with 〈 34 weeks＇ gestation, were higher than other gestational age with statistically significant difference （ P 〈 0.05 ） ; Cesarean delivery caused neonatal death, asphyxia, RDS, HIE, and mater-nal eclampsia,postpartum hemorrhage and the incidence of puerperal infection were lower than those of the vagina delivery（P 〈 0.05 ）. Conclusion Timely termination of pregnancy with severe preeclampsia and eelampsia can improve the perinatal survival rate,36 weeks of pregnancy termination of gestation has mini- mum impact on the perinatal infant, and Cesarean delivery is an effective way for termination of gestation of severe preeclampsia and eclampsia.