妊娠高血压终止妊娠的时机和分娩方式的选择

Determination of the time and method of delivery of hypertensive disorders in pregnancy

目的 探讨妊娠高血压疾病终止妊娠的时机和分娩方式的选择及对母婴结局的影响.方法 选择2012年3月-2013年2月收治的146例妊娠高血压疾病患者作为研究对象,按照终止妊娠的时机分为≥36周组、＜36周组,按照分娩方式分为剖宫产组及阴道分娩组,比较分析母婴结局.结果 ≥36周组的新生儿窒息率为2.4％,明显低于＜36周组的15.6％,组间差异有统计学意义（P＜0.05）;两组产妇产后并发症发生率比较,差异无统计学意义（P＞0.05）;剖宫产组产妇产后感染发生率为9.4％,明显高于阴道分娩组的2.0％,组间差异有统计学意义（P＜0.05）;两组新生儿不良事件发生率比较,差异无统计学意义（P＞0.05）.结论 妊娠高血压疾病应该根据病情积极治疗,尽量延长孕周至足月,同时剖宫产是妊娠高血压疾病的最佳分娩方式,适时恰当地选择剖宫产能够更好地保证母婴安全.

Objective To explore the effects of time and method of delivery of hypertensive disorders in pregnancy on maternal and neonatal outcomes.Methods 146 cases of hypertensive disorders in pregnancy were selected as the research subjects,and they were divided into ≥ 36 weeks,＜36 weeks group according to the time of delivery,and divided into cesarean section group and vaginal delivery group according to the method of delivery.The maternal and neonatal outcomes were compared.Results The neonatal asphyxia rate of ≥36 weeks group （2.4％） was significantly lower than ＜36 weeks group （15.6 ％）.The difference was statistically significant between two groups （P＜0.05）.The incidence of postpartum infection of two groups had no statistically significant difference （P＞0.05）.The incidence of postpartum complication of cesarean section group was 9.4％,significantly higher than 2.0％ of the vaginal delivery group （P＜ 0.05）.The neonatal adverse events of two groups had no statistically significant difference （P＞0.05）.Conclusion Hypertensive disorders in pregnancy should be actively treated according to the disease,try to extend the gestation,and pregnancy cesarean section is the best method of delivery,So timely and felicitously selecting cesarean section can better ensure the mother-infant safety.