242例危重孕产妇临床分析

Analysis of 242 critically ill pregnant women

目的对我院242例危重孕产妇的致病因素以及妊娠结局进行研究分析,以便为临床保障危重孕产妇及围产儿的生命安全提供可靠的依据。方法回顾性分析242例危重孕产妇的临床资料,按照产妇的危重情况,将242例产妇分为A组[有严重妊娠并发症但无生命威胁的孕产妇(WLTC),144例]、B组[濒临死亡的孕产妇(MNM),95例]以及C组[死亡孕产妇(MD),3例],研究分析三组患者临床合并的主要疾病类型,比较B+C组和A组妊娠结局。结果B组子痫、胎盘种植异常的产妇比例高于A组,差异均有统计学意义(P<0.05)。B+C组和A组妊娠结局分析,B+C组院外分娩比例(8.16%)、输血比例(54.08%)、子宫切除比例(15.31%)、髂内子宫动脉栓塞发生率(21.43)均高于A组(0,25.69%,0,4.86%),差异均有统计学意义(P<0.05)。结论子痫、胎盘种植异常是导致MNM产生的主要因素,院外分娩、输血、子宫切除、髂内子宫动脉栓塞是MNM与MD最常见的原因。

Objective To study and analyze the pathogenic factors and pregnancy outcomes of 242 cases of critically ill pregnant women in our hospital,in order to provide reliable clinical diagnosis and treatment data for clinical protection of the life safety of critically ill pregnant women and perinatal infants Methods Retrospective analysis of clinical data of 242 critically ill pregnant women,during the study,242 mothers were divided into the group A[pregnant women with severe pregnancy complications but not life-threatening(WLTC),144 cases]and the group B[pregnant women on the verge of death(MNM)according to the critical condition of the mothers,95 cases]and the group C[dead pregnant women(MD),3 cases].The study analyzed the main clinical disease types and the proportion of the three groups of patients,and compared the pregnancy outcomes of the B+C group and the group A.Results The proportion of women with eclampsia and abnormal placenta implantation in group B was higher than that in group A,and the difference was statistically significant(P<0.05).Analysis of pregnancy outcomes in the groups B+C and the group A,the proportion of out-of-hospital delivery(8.16%),blood transfusion(54.08%),hysterectomy(15.31%),and incidence of internal iliac uterine artery embolism(21.43)in the group B+C were higher than those in the group A(0,25.69%,0,4.86%),the difference was statistically significant(P<0.05).Conclusion Eclampsia,abnormal placental implantation are the main factors leading to MNM.Out-of-hospital delivery,blood transfusion,hysterectomy,and internal iliac uterine artery embolization are the most common reason of MNM and MD.