早发型重度子痫前期患者不同终止妊娠时机、分娩方式对母婴结局的影响分析

Analysis of the influence of different termination time and delivery mode on maternal and infant outcomes in patients with early onset severe preeclampsia

目的 研究早发型重度子痫前期患者不同终止妊娠时机、分娩方式对母婴结局的影响效果。方法 选取50例早发型重度子痫前期患者,根据终止妊娠时间分为A组(16例,终止妊娠时间<32周)、B组(17例,终止妊娠时间32~34周)及C组(17例,终止妊娠时间>34周)。然后根据分娩方式分为自然分娩组(18例)与剖宫产组(32例)。比较各组母婴结局。结果 B组保守治疗时间(14.04±3.29)d长于A组(6.93±2.30)d以及C组(6.72±3.05)d(P<0.05);三组入院24 h尿蛋白水平比较,差异无统计学意义(P>0.05)。三组孕期并发症发生率比较,差异无统计学意义(P>0.05)。A组围生儿死亡率、新生儿窒息率高于B组、C组,出生体质量、Apgar评分均低于B组、C组(P<0.05);三组死胎率、胎儿宫内发育迟缓率、胎儿窘迫率比较,差异无统计学意义(P>0.05)。自然分娩组围生儿死亡率、胎儿窘迫率、新生儿窒息率高于剖宫产组,新生儿的Apgar评分低于剖宫产组(P<0.05)。两组死胎率、胎儿宫内发育迟缓率比较,差异无统计学意义(P>0.05)。结论 早发型重度子痫前期患者在孕龄达34周以上,可获得良好的母婴结局,新生儿存活率更高,采用剖宫产分娩可保证围生儿生命安全。

Objective To study the effects of different timing of pregnancy termination and delivery mode on maternal and infant outcomes in patients with early-onset severe preeclampsia.Methods 50 patients with early-onset severe preeclampsia were selected and divided into group A(16 cases,duration of termination of pregnancy<32 weeks),Group B(17 cases,duration of termination of pregnancy>34 weeks)and group C(17 cases,duration of termination of pregnancy>34 weeks)according to the time of termination of pregnancy.Then they were divided into natural delivery group(18 cases)and cesarean section group(32 cases).The outcomes of mothers and infants in each group were compared.Results The conservative treatment time of group B(14.04±3.29)d was longer than that of group A(6.93±2.30)d and group C(6.72±3.05)d(P<0.05).There was no significant difference in urinary protein level at 24 h after admission among the three groups(P>0.05).There was no significant difference in the incidence of pregnancy complications among the three groups(P>0.05).The perinatal mortality rate and neonatal asphyxia rate in group A were higher than those in groups B and C,and the birth weight and Apgar score in group A were lower than those in groups B and C(P<0.05).There was no significant difference in the rate of stillbirth,intrauterine growth retardation and fetal distress among the three groups(P>0.05).The perinatal mortality rate,fetal distress rate and neonatal asphyxia rate of the natural delivery group were higher than those of the cesarean section group,and the Apgar score of the newborns was lower than that of the cesarean section group(P<0.05).There was no significant difference in stllbirth rate and intrauterine growth retardation rate between the two groups(P>0.05).Conclusion Patients with early-onset severe preeclampsia who are more than 34 weeks of gestation age can obtain good maternal and infant outcomes,and the newborn survival rate is higher.Caesarean delivery can ensure the life safety of perinatal infants.