80例早发型重度子痫前期患者母体和围生儿预后及影响因素分析

Analysis on maternal and perinatal outcomes and influencing factors in 80 patients with early-onset severe preeclampsia

目的探讨早发型重度子痫前期(EOSPE)患者母体和围生儿预后及相关影响因素,为临床治疗提供参考依据。方法回顾性分析2012年5月-2016年12月该院收治的80例EOSPE孕妇的临床资料,探讨母体妊娠结局、相关并发症、围生儿结局及相关影响因素。结果母体合并相关严重并发症共29例(36.3%),其中7例(8.8%)同时合并2个及以上相关并发症。84例围生儿中总共死亡32例,死亡率38.1%。母体合并严重并发症围生儿总共死亡19例,占死亡围生儿的59.4%。导致围生儿死亡的常见母体并发症依次为:胎盘早剥、子痫前期、HELLP综合征、心功能不全、肾功能不全、视网膜脱离。Logistic回归分析结果显示:规律产检、分娩孕周、胎盘早剥、新生儿出生体质量、胎儿生长受限、期待治疗天数是影响围生儿死亡的独立危险因素。结论 EOSPE孕妇围生儿死亡率高。在严密监护的情况下,加强围生期预防保健、积极防治并发症、适时终止妊娠可以改善围生儿预后。

Objective To explore maternal and perinatal outcomes and influencing factors in 80 patients with early-onset severe preeclampsia,provide a reference basis for clincal treatment. Methods The clinical data of 80 patients with early-onset severe preeclampsia treated in Yancheng Maternal and Child Health Care Hospital from May 2012 to December 2016 was analyzed retrospectively. Maternal pregnancy outcome,related complications,perinatal outcome,and related influencing factors were observed. Results Among 80 patients,29 patients(36. 3%） were found with severe maternal complications,and 7 patients(8. 8%） were found with two or more than two related complications. Among 84 perinatal infants,perinatal death occurred in 32 cases,the mortality rate was 38. 1%. Nineteen perinatal infants died of severe maternal complications,accounting for 59. 4%. The common maternal complications inducing perinatal death included placental abruption,preeclampsia,HELLP syndrome,cardiac insufficiency,renal insufficiency,and retinal detachment. Logistic regression analysis showed that regular prenatal examination,gestational week,placental abruption,neonatal birth weight,fetal growth restriction,and time of expectant treatment were independent risk factors for perinatal mortality. Conclusion Perinatal mortality rate in patients with early-onset severe preeclampsia is high. In the case of intensive care,strengthening perinatal health care,active prevention and treatment of complications,and timely termination of pregnancy can improve perinatal outcome.