早发型重度子痫前期患者不同孕周终止妊娠对母婴结局的影响

Effect of termination of pregnancy in different gestational weeks on maternal and infantile outcomes in patients with early-onset severe preeclampsia

目的探讨早发型重度子痫前期患者终止妊娠的时机对母婴结局的影响。方法对80例早发型重度子痫前期孕妇的临床资料进行回顾性分析,按照终止妊娠孕周将其分为A组23例、B组28例、C组29例,其中A组为孕周<32周终止妊娠、B组为孕周32~33+6周终止妊娠、C组为孕周≥34周终止妊娠,比较3组产妇并发症的发生情况及围生儿的结局。结果 A、B、C组产妇产前严重并发症的发生率分别为52.17%、46.43%、48.28%,随着终止妊娠孕周的延长,产前严重并发症的发生率无明显变化,3组间差异无统计学意义(P>0.05);而对不同终止妊娠孕周新生儿窒息、围生儿死亡的发生率差异有统计学意义(P<0.05),随着终止妊娠孕周的延长,新生儿窒息、围生儿死亡的发生率明显下降,差异有统计学意义(P<0.05)。结论早发型重度子痫前期患者终止妊娠的时机对围生儿结局会造成影响,对病情稳定的患者采取期待治疗,如果出现严重母婴并发症,就应及时终止妊娠,从而改善母婴结局。

Objective To explore the effect of termination of pregnancy in different gestational weeks on maternal and infantile out- comes in patients with early-onset severe preeclampsia. Methods The clinical data of eighty pregnant women with early-onset severe pre- echlmpsia was analyzed retrospectively, then they were divided into group A （23 cases）, group B （28 cases）, and group C （29 cases） ; the cases in group A terminated pregnancy less than 32 gestational week, the cases in group B terminated pregnancy during 32-33＋6 gestational weeks, the cases in group C terminated pregnancy at 34 gestational week or more than 34 gestational week; the incidence rates of complica- tions and neonatal outcomes in the three groups were compared. Results The incidence rates of maternal prenatal severe complications in group A, group B, and group C were 52. 17%, 46.43%, and 48.28%, respectively; the incidence rates of maternal prenatal severe com- plications didn＇t change significantly with the extension of gestational week, there was no statistically significant difference among the three groups （ P〉0. 05 ） ; there was statistically significant difference in the incidence rate Of neonatal asphyxia and perinatal mortality among the three groups （ P〈0. 05 ） ; the incidence rate of neonatal asphyxia and perinatal mortality decreased significantly with the extension of gesta- tional week, there was statistically significant difference among the three groups （P〈0.05） . Conclusion The opportunity to terminate pregnancy has impact on perinatal outcome in early-onset severe preeclampsia patients, termination of pregnancy is necessary when severe maternal and infantile complications occur to improve maternal and infantile outcomes.