Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, featu...Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women. Methods Four hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows： group A （less than 32 weeks, 73 cases）, group B ,（between 32 and 34 weeks, 71 cases）, and group C （greater than 34 weeks, 269 cases）. The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively. Results The systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome. Conclusions Early onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.展开更多
目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组...目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。展开更多
目的：探讨早发型重度子痫前期（early onset severe preeclampsia，EOSP）诊断孕周对孕产妇及其围产儿结局影响的临床风险因素。方法将356例重度子痫前期孕产妇按诊断孕周分为3组：＜32孕周 EOSP 组（A 组）154例、32～34孕周 EOSP 组...目的：探讨早发型重度子痫前期（early onset severe preeclampsia，EOSP）诊断孕周对孕产妇及其围产儿结局影响的临床风险因素。方法将356例重度子痫前期孕产妇按诊断孕周分为3组：＜32孕周 EOSP 组（A 组）154例、32～34孕周 EOSP 组（B 组）50例和＞34孕周 SP 组（C 组）152例。采集3组的人口统计学特征、孕产妇并发症、分娩方式、实验室检查及围产儿结局等临床信息，进行回顾性分析。结果A 组的以往子痫前期病史比例和入院时收缩压／舒张压值数值显著高于 B 组和 C 组（P ＜0．05）；A 组的规范产检比例低于 B 组和 C 组，且与 C 组差异有统计学意义（P ＜0．05）。在24 h 尿蛋白总量、入院时舒张压和缓解病情所需住院治疗时间的比较中，A 组和 B组与 C 组比较差异有统计学意义（P ＜0．01）。A 组、B 组的总临床并发症、肝功能损害、肾功能损害与 C 组比较，差异有统计学意义（P ＜0．05）。A 组的胎盘早剥发生率与 C 组比较差异有统计学意义（P ＜0．05）。单因素分析显示，发病孕周、24 h 尿蛋白水平、双胎妊娠、三胎妊娠、产前检查次数均为早发型重度子痫前期孕产妇住院时间延长的风险因素。A 组患者的胎儿引产率和新生儿死亡率与 B 组、C 组相比差异有统计学意义（P ＜0．05）。死胎、新生儿窒息的发生率 A、B、C 3组间差异均有统计学意义（P ＜0．05）。围产儿死亡相关因素中 OR 值＜1的有：孕产妇发病孕周、住院时间和孕产妇规范产前检查次数；OR 值＞1的有：孕产妇并发肾功能衰竭、并发胎盘早剥和并发心功能不全，差异均有统计学意义（P ＜0．05）。结论EOSP 发病孕周＜32周具有病情重、并发症多、孕产妇及围产儿不良预后发生率高的特点。因此，提前2周诊断 EOSP，即以＜32孕周划分 EOSP，对及时治疗重度子痫前期尤其是早发性重度子痫前期孕产妇、减少或延迟并发症的发生、最大限度降低孕产妇及围产儿不良结局的发生弥足珍贵。展开更多
文摘Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women. Methods Four hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows： group A （less than 32 weeks, 73 cases）, group B ,（between 32 and 34 weeks, 71 cases）, and group C （greater than 34 weeks, 269 cases）. The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively. Results The systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome. Conclusions Early onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.
文摘目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。
文摘目的：探讨早发型重度子痫前期（early onset severe preeclampsia，EOSP）诊断孕周对孕产妇及其围产儿结局影响的临床风险因素。方法将356例重度子痫前期孕产妇按诊断孕周分为3组：＜32孕周 EOSP 组（A 组）154例、32～34孕周 EOSP 组（B 组）50例和＞34孕周 SP 组（C 组）152例。采集3组的人口统计学特征、孕产妇并发症、分娩方式、实验室检查及围产儿结局等临床信息，进行回顾性分析。结果A 组的以往子痫前期病史比例和入院时收缩压／舒张压值数值显著高于 B 组和 C 组（P ＜0．05）；A 组的规范产检比例低于 B 组和 C 组，且与 C 组差异有统计学意义（P ＜0．05）。在24 h 尿蛋白总量、入院时舒张压和缓解病情所需住院治疗时间的比较中，A 组和 B组与 C 组比较差异有统计学意义（P ＜0．01）。A 组、B 组的总临床并发症、肝功能损害、肾功能损害与 C 组比较，差异有统计学意义（P ＜0．05）。A 组的胎盘早剥发生率与 C 组比较差异有统计学意义（P ＜0．05）。单因素分析显示，发病孕周、24 h 尿蛋白水平、双胎妊娠、三胎妊娠、产前检查次数均为早发型重度子痫前期孕产妇住院时间延长的风险因素。A 组患者的胎儿引产率和新生儿死亡率与 B 组、C 组相比差异有统计学意义（P ＜0．05）。死胎、新生儿窒息的发生率 A、B、C 3组间差异均有统计学意义（P ＜0．05）。围产儿死亡相关因素中 OR 值＜1的有：孕产妇发病孕周、住院时间和孕产妇规范产前检查次数；OR 值＞1的有：孕产妇并发肾功能衰竭、并发胎盘早剥和并发心功能不全，差异均有统计学意义（P ＜0．05）。结论EOSP 发病孕周＜32周具有病情重、并发症多、孕产妇及围产儿不良预后发生率高的特点。因此，提前2周诊断 EOSP，即以＜32孕周划分 EOSP，对及时治疗重度子痫前期尤其是早发性重度子痫前期孕产妇、减少或延迟并发症的发生、最大限度降低孕产妇及围产儿不良结局的发生弥足珍贵。
