早发型重度子痫前期发病与母儿结局的临床研究

Clinical Research of Early Onset Severe Preeclampsia and Maternal and Infant Outcomes

目的探讨早发型重度子痫前期对母婴结局的影响。方法将2010年2月至2013年12月在应城市人民医院收治的重度子痫前期产妇116例按照发病孕周分为A组（发病孕周为29～31周，28例），B组（发病孕周为32—34周，30例），C组（发病孕周〉34周，58例）。对比三组的临床症状和妊娠结局。结果三组产妇总并发症发生率差异有统计学意义[92．9％（26／28）比73．3％（22／30）比36．2％（21／58），P〈0．05]，其中，A组高于B组和c组，B组高于C组（P〈0．05）。A组、B组终止妊娠时间显著早于c组[（31．29±0．91）周，（33．96±1．02）周比（36．09±1．24）周]，差异有统计学意义（P〈O．05）。A组和B组胎儿宫内窘迫发生率显著高于c组[50．O％（14／28），26．7％（8／30）比6．9％（4／58），P〈0．05]；A组死胎发生率显著高于c组[25．O％（7／28），5．2％（3／58），P〈0．05]，A组婴儿窒息发生率、转新生儿重症监护发生率、低体质量儿发生率显著高于B组和C组[32．1％（9／28）比7．0％（2／30），6．9％（4／58）；53．6％（15／28）比23．3％（7／30），10．3％（6／58）；32．1％（9／28）比2．0％（6，，30），5．2％（3／58），P〈0．05]，B组低体质量儿发生率显著低于c组，差异有统计学意义（P〈0．05）。结论早发型重度子痫前期发病孕周早，产妇病情进展快，对母婴结局具有不良影响。

Objective to study the influence of early onset severe preeclampsia on maternal and infant outcomes. Methods During Feb. 2010 and Dec. 2013 in Yinchen People＇s Hospital, 116 pregnant women with severe preeclampsia were divided into the three groups according to the gestational age：28 cases of onset at gestational age of 29-31 weeks as group A,30 cases of onset at 32-34 weeks as group B,58 cases of onset at gestational age 〉 34 weeks as group C. The clinical symptoms and pregnancy outcome of the three groups were compared. Results The overall maternal complications had statistically significant differences [ 92. 9% （26/28） vs 73.3% （22/301） vs 36.2% （21/58） ,P 〈0. 05] ,group A higher than group B and C,group B higher than group C （ P 〈 0. 05 ）. The termination time of group A and group B was obviously earlier than group C [ （31.29 ± 0. 91 ） weeks, （33.96 ± 1.02 ） weeks vs （36.09 ± 1.24 ） weeks, P 〈 O. 05 ]. The inci- dence of fetal distress of group A and B group statistically higher than group C [ 50.0 % （ 14/28 ） ,26.7 % （ 8/ 30 ） vs 6. 9% （4/58）, P 〈 0. 05 ]. The stillbirth rate of group A was statistically higher than group C [ 25.0% （7/28） ,5.2% （3/58）,P 〈0. 05 ], incidence of infant asphyxia, the incidence of neonatal intensive care, the incidence of low body mass of group A were significantly higher than group B and C [ 32. 1% （9/28） vs 7.0%（2/30） ,6.9% （4/58）;53.6% （15/28） vs 23.3% （7/30）,10.3% （6/58）;32. 1% （9/28） vs 2. 0% （6/30） ,5.2% （3/58）, P 〈 0. 05 ], the incidence of low body mass of group B was significantly lower than group C, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Early onset severe pre- eclampsia is a critical disease, with quick progress, and has a great impact on the maternal and fetal/neonatal outcomes.