初发与再发子痫前期的临床特点及母婴结局的研究

Study on the clinical characteristics and maternal and infant outcome of recurrent preeclampsia

目的:探讨子痫前期(Preeclampsia,PE)初发与复发时的临床特点及对妊娠结局的影响,为疾病的预防和治疗提供新思路。方法:收集2018年1月-2019年12月于我院住院并分娩的PE患者病例资料277例,进行回顾性分析。其中初产妇初发组(First time occurring preeclampsia of primipara group,PPE组)70例,经产妇初发组(First time occurring preeclampsia of multipara group,MPE组)125例,子痫前期再发组(Recurrent preeclampsia,RPE组)82例。结果:RPE组的(Systolic-diastolic ratio of umbilical cord blood flow,S/D)比值、尿蛋白定性、尿酸值、新生儿黄疸发生率均高于MPE组;分娩孕周与血小板计数则小于MPE组(P<0.05)。与PPE组相比,RPE组分娩孕周更早,血小板更少,子痫前期发病率更高,新生儿出生即刻Apgar评分更低(P<0.05)。MPE组比PPE组的产检率更小(P<0.05)。结论:与初发PE患者相比,再发PE患者的分娩孕周提前,病情严重程度更高,妊娠结局不良。此外,再发组的患者缺乏对疾病的足够认识和规范产检。因此应提高防范PE复发的意识,规范产检和孕期管理,避免不良结局的发生。

Objective:To investigate the clinical characteristics of recurrence of preeclampsia(PE)and its influence on pregnancy outcome,so as to provide new ideas for disease prevention and treatment.Methods:The data of 277 cases of PE patients who were hospitalized and delivered in our hospital from January 2018 to December 2019 were collected and retrospectively analyzed.Among them,70 cases were the first-onset preeclampsia of primipara group(PPE group),125 cases were the first time occurring preeclampsia of multipara group(MPE group),and 82 cases were the recurrent preeclampsia group(RPE group).Results:The S/D ratio,qualitative urine protein,uric acid value,and incidence of neonatal jaundice in the RPE group were higher than those in the MPE group;the proportion of regular obstetrics,the gestational week and the platelet count were lower than those in the MPE group(P<0.05).Compared with the PPE group,the RPE group has an earlier gestational week,fewer platelets,a higher incidence of preeclampsia,and a lower Apgar score immediately after birth,differences(P<0.05).The rate of prenatal examination in MPE group was lower than that in PPE group(P<0.05).Conclusion:Compared with patients of first-onset PE,the patients of recurrent PE have an earlier delivery gestational week,a higher severity of the disease,and a poor pregnancy outcome.In addition,patients in the recurrence group lack sufficient knowledge of the disease and standardized delivery inspection.Therefore,the awareness of preventing PE recurrence should be raised,and the obstetric examination and pregnancy management should be standardized to avoid the occurrence of adverse outcomes.