早发型重度子痫前期合并胎儿生长受限期待治疗的妊娠结局探讨

Exploring the pregnancy outcome of expectant treatment for early-onset severe preeclampsia complicated with fetal growth restriction

目的分析早发型重度子痫前期合并胎儿生长受限期待治疗的妊娠结局。方法选取60例早发型重度子痫前期合并胎儿生长受限及未合并胎儿生长受限的产妇,其中合并胎儿生长受限的产妇30例纳入观察组,未合并胎儿生长受限的产妇30例纳入对照组。两组均采取期待治疗。比较两组产妇的并发症发生情况,围生期情况,新生儿并发症发生情况,观察组不同分娩孕龄围生儿结局。结果两组子痫、心力衰竭、胎盘早剥、单纯肝功能异常、单纯血小板减少、HELLP综合征发生率比较,均无显著差异(P>0.05)。观察组新生儿死亡率20.00%高于对照组的3.33%,新生儿出生体质量(1294.19±308.30)g低于对照组的(1599.25±392.28)g(P<0.05);两组剖宫产率、因胎儿因素终止妊娠率、分娩孕龄比较,均无显著差异(P>0.05)。观察组新生儿肺透明膜病发生率26.67%、心脏发育不全发生率23.33%高于对照组的3.33%、0(P<0.05);两组新生儿败血症、颅内出血、贫血发生率比较,均无显著差异(P>0.05)。观察组孕龄32周以上出生的围生儿死亡率0、心脏发育不全发生率5.26%、肺透明膜病发生率5.26%均低于孕龄30周以下围生儿的66.67%、66.67%、66.67%和孕龄30~31+6周围生儿的50.00%、50.00%、62.50%(P<0.05)。结论对早发型重度子痫前期合并胎儿生长受限的产妇实施期待治疗,不会增加产妇并发症,安全性较高。虽然围生儿死亡率、出生体质量、并发症发生率等指标较差,但是随着分娩孕龄的延长,围生儿的结局会有所改善,因而该方法具有较高的应用价值。

Objective To analyze the pregnancy outcome of expectant treatment for early-onset severe preeclampsia complicated with fetal growth restriction.Methods A total of 60 maternal women with early-onset severe preeclampsia with or without fetal growth restriction were selected.Among them,30 maternal women with combined fetal growth restriction were included in the observation group,while 30 maternal women without combined fetal growth restriction were included in the control group.Both groups were treated with expectant therapy.The maternal complications,perinatal situation,and neonatal complications were compared between the two groups.The perinatal outcomes at different gestational ages in the observation group were compared.Results There were no significant differences between the two groups in terms of incidence of eclampsia,heart failure,placental abruption,simple liver dysfunction,simple thrombocytopenia and HELLP syndrome(P>0.05).The neonatal mortality rate of 20.00%in the observation group was higher than 3.33%in the control group,and the neonatal birth weight of(1294.19±308.30)g was lower than(1599.25±392.28)g in the control group(P<0.05).There were no significant differences in the cesarean section rate,pregnancy termination rate due to fetal factors,and gestational age at delivery between the two groups(P>0.05).The incidence rate of neonatal pulmonary hyaline membrane disease and cardiac hypoplasia were 26.67%and 23.33%in the observation group,which were higher than 3.33%and 0 in the control group(P<0.05).There were no significant differences in the incidence of neonatal sepsis,intracranial hemorrhage and anemia between the two groups(P>0.05).In the observation group,the neonatal mortality rate of perinatal infants at over 32 weeks of gestation was 0,the incidence rate of cardiac hypoplasia was 5.26%,and the incidence rate of neonatal pulmonary hyaline membrane disease was 5.26%,all of which were lower than 66.67%,66.67%and 66.67%of perinatal infants at under 30 weeks of gestation,and 50.00%,50.00%and 62.50%of perinatal infants at 30-31+6 weeks of gestation(P<0.05).Conclusion Implementing expectant treatment for patients with early-onset severe preeclampsia combined with fetal growth restriction will not increase maternal complications and has high safety.Although indicators such as perinatal mortality rate,birth weight,and incidence of complications are poor,the outcome of perinatal infants will improve with the prolongation of gestational age.Therefore,this method has high application value.