早发型重度子痫前期患者终止妊娠时机对母儿结局的影响分析

Effect of termination pregnancy time on maternal and neonatal outcome in early onset severe preeclampsia

目的探讨早发型重度子痫前期患者终止妊娠时机对母儿结局的影响。方法选取2011年11月至2012年12月在我院诊治的早发型重度子痫前期患者120例为研究对象,按照终止妊娠时机分为A组和B组,每组60例,A组患者孕周<32周、32周≤B组患者孕周<34周终止妊娠,比较分析两组患者并发症如胎盘早剥、子痫等的发生情况,以及两组患者新生儿窒息、胎死宫内、围产儿死亡情况。结果 A、B两组患者发生的并发症主要为低蛋白血症,发生率分别76.7%和78.3%;A组胎儿窘迫的发生率(25.0%)显著高于B组(5.0%),差异有统计学意义(P<0.01);两组患者胎盘早剥、子痫等并发症发生率比较差异无统计学意义(P>0.05)。两组患者围产儿新生儿窒息、胎死宫内发生率比较差异无统计学意义(P>0.05);A组患者围产儿死亡发生率(35.0%)显著高于B组(11.7%),差异有统计学意义(P<0.01)。结论早发型重度子痫前期患者过早终止妊娠(<32孕周)对母儿结局会产生较大不良影响,终止妊娠时机选择在"32周≤终止妊娠<34周",能最大限度保证围产儿的生存率和患者健康。

Objective To investigate the effect of termination pregnancy time on maternal and neonatal outcome in early onset severe preeclampsia. Methods A total of 120 patients with early onset severe preeclampsia admitted to our hospital from November 2011 to December 2012 were divided into groups A（termination time 〈 32weeks） and B（32 ≤ termination time〈 34 weeks） according to the gestational weeks of termination of pregnancy,with 60 cases in each group,the rate of placental abruption, eclampsia, neonatal asphyxia, intrauterine death, perinatal death were compared between two groups.Results Hypoproteinemia was major complication,the incidence rate of hypoproteinemia in the group A was 76. 7%,and group B was 78. 3%; the incidence rate of fetal distress in group A（25. 0%） was significantly higher than that in group B（5. 0%,P 〈 0. 05）; there was no significant difference in incidence rates of placental abruption,eclampsia,neonatal asphyxia,intrauterine death between two groups（P 〉 0. 05）; the incidence rates of perinatal death in group A（35. 0%） was significantly higher than that in group B（11. 7%,P 〈 0. 05）. Conclusions For the patients with early onset severe preeclampsia,earlier onset gestational week causes worse perinatal outcome,32≤termination time 〈 34 weeks was the best time of pregnancy termination,which can improve survival rate and ensure health.