早发型重度子痫前期合并胎儿生长受限期待治疗的妊娠结局分析

Analysis on pregnancy outcome of expectant treatment of early-onset severe preeclampsia combined with fetal growth restriction

目的探索期待治疗中早发型重度子痫前期合并胎儿生长受限(FGR)的母儿结局。方法选择2009年1月-2015年1月在该院产科进行期待治疗的97例早发型重度子痫前期患者为研究对象,其中合并FGR者38例(研究组),未合并FGR者59例(对照组),回顾性分析两组患者临床资料,对比两组母儿结局。结果两组孕产妇子痫、胎盘早剥、HELLP综合征、心衰及血小板减少发生率比较,差异均无统计学意义(P>0.05)。两组孕产妇剖宫产率和产后出血率比较,差异均无统计学意义(P>0.05);研究组早产率较对照组明显增加(P<0.05),终止妊娠时间较对照组明显缩短(P<0.05)。两组新生儿黄疸发生率比较,差异无统计学意义(P>0.05);研究组新生儿窒息、肺透明膜病变、心脏发育不全、新生儿贫血及新生儿死亡发生率均较对照组明显增加(P<0.05)。结论期待治疗不会增加早发型重度子痫前期合并FGR孕产妇并发症的发生率,且能改善其分娩结局和新生儿结局,因此,尽早发现、积极预防并适时终止妊娠,对改善母婴预后具有重要意义。

Objective To explore maternal and infantile outcomes of early-onset severe preeclampsia（ EOSP） combined with fetal growth restriction（ FGR） during expectant treatment.Methods Ninety-seven patients with EOSP receiving expectant treatment in Department of Obstetrics in the hospital from January 2009 to January 2015 were selected and divided into study group（ 38 patients with FGR） and control group（ 59 patients without FGR）.The clinical data was analyzed retrospectively;maternal and infantile outcomes in the two groups were compared.Results There was no statistically significant difference in the incidence rates of eclampsia,placental abruption,HELLP syndrome,heart failure,and thrombocytopenia between the two groups（ P〉0.05）.There was no statistically significant difference in cesarean section rate and the incidence rate of postpartum hemorrhage between the two groups（ P〉0.05）.The rate of premature delivery in study group was statistically significantly higher than that in control group（ P〈0.05）,the time for termination of pregnancy in study group was statistically significantly shorter than that in control group（ P〈0.05）.There was no statistically significant difference in the incidence rate of neonatal jaundice between the two groups（ P 〉 0.05）.The incidence rates of neonatal asphyxia,neonatal hyaline membrane disease,heart hypoplasia,neonatal anemia and neonatal mortality in study group were statistically significantly higher than those in control group（ P〈0.05）.Conclusion Expectant treatment does not increase the incidence rates of complications of pregnant women with EOSP combined with FGR,and it can improve birth outcomes and neonatal outcomes,so early detection,active prevention and timely termination of pregnancy play important roles in improving maternal and infantile prognosis.