不同类型妊娠期高血压疾病对妊娠结局的影响

Effect of different types of hypertensive disorder complicating pregnancy on pregnancy outcome

目的:探讨不同类型妊娠期高血压疾病(DHCP)对妊娠结局的影响。方法:采用简单抽样法,选取合并不同类型DHCP孕妇168例为观察组,随机选取同时期的正常孕妇168例为对照组,详细记录、统计并分析产妇、胎儿及新生儿的不良结局。结果:观察组围产妇不良结局总发生率为48.81%,对照组3.57%。2组产妇除妊娠期高血压心脏病并发症发生率差异无统计学意义(P>0.05)外,观察组产妇胎盘早剥等并发症发生率均高于对照组(P<0.05~P<0.01),观察组产妇合并2种并发症发生率高于对照组(P<0.01),而2组产妇合并3种并发症发生率差异无统计学意义(P>0.05)。观察组胎儿不良结局总发生率为58.42%,对照组为6.90%。观察组胎儿死亡、宫内窘迫、胎儿生长受限发生率均高于对照组(P<0.05~P<0.01),观察组胎儿合并2种并发症发生率高于对照组(P<0.01),而2组胎儿合并3种并发症发生率差异无统计学意义(P>0.05)。观察组围新生儿不良结局总发生率为46.55%,对照组为4.93%。观察组新生儿窒息、小于胎龄儿发生率均高于对照组(P<0.01),观察组新生儿合并2种并发症发生率高于对照组(P<0.01),而2组新生儿死亡及合并3种并发症发生率差异无统计学意义(P>0.05)。妊娠期高血压、子痫前期、子痫、妊娠合并慢性高血压和慢性高血压并发子痫前期围产妇胎盘早剥、胎儿死亡、新生儿死亡等不良结局发生率差异均无统计学意义(P>0.05)。结论:DHCP严重影响围产妇母婴预后,且随着疾病进程的发展,影响逐渐增加。临床应加强筛查,尽早发现和干预,改善母婴预后质量。

Objective:To explore the effects of different types of hypertensive disorder complicating pregnancy(HDCP)on pregnancy outcome.Methods:One hundred and sixty-eight pregnant women with different types of HDCP were selected using simple sampling,and set as the observation group.One hundred and sixty-eight normal pregnant women in the same period were set as the control group.The adverse outcomes of pregnant womanl,fetus and neonate were recorded,counted and analyzed in two groups.Results:The total incidence rates of adverse outcomes in perinatal stage in observation group and control group were 48.81%and 3.57%,respectively.Except for the HDCP,the difference of the incidence rate of other complications between two groups was not statistically significant(P>0.05).The incidence rate of placenta abruption complications in observation group was higher than that in control group(P<0.05 to P<0.01).The incidence rate of two kinds of complications in observation group was higher than that in control group(P<0.01),and the difference of the incidence rate of three kinds of complications between two groups was not statistically significant(P>0.05).The incidence rate of adverse outcomes of fetuses in observation group and control group were 58.42%and 6.90%,respectively.The incidence rates of fetal death,fetal distress and fetal growth restriction of fetus in observation group were higher than those in control group(P<0.05 to P<0.01).The incidence rate of two kinds of complications in fetuses of observation group was higher than that in control group(P<0.01),and the difference of the incidence rate of three kinds of complications in fetuses between two groups was not statistically significant(P>0.05).The incidence rate of neonatal adverse outcomes during perinatal period in observation group and control group were 46.55%and 4.93%,respectively.The incidence rates of the neonatal asphyxia and SGA in observation group were higher than those in control group(P<0.01).The incidence rate of two kinds of complications in neonates in observation group was higher than that in control group(P<0.01),and the differences of the incidence rates of death and three kinds of complications of neonates were not statistically significant(P>0.05).The differences of the incidence rates of gestational hypertension,preeclampsia,eclampsia,pregnancy complicated with chronic hypertension,chronic hypertension complicated with preeclampsia perinatal placental abruption,fetal death and neonatal death between two groups were not statistically significant(P>0.05).Conclusions:HDCP can seriously impact on the maternal and infant prognosis,and the effects gradually increase with the development of disease.Strengthening the screening,early detection and intervention should be done to improve the quality of maternal and infant prognosis.