67例早发型重度子痫前期患者围产儿预后分析  

Perinatal outcomes and risk factors in patients with early-onset severe preeclampsia

作　　者：龙燕[1] 蔺莉[1] 郭艳阳[1] 靳家玉[1] 

机构地区：[1]首都医科大学附属北京友谊医院妇产科,100050

出　　处：《中国妇产科临床杂志》2011年第3期172-175,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的目的探讨67例早发型重度子痫前期患者围产儿预后及相关影响因素。方法回顾性分析2003年12月-2010年3月在北京友谊医院妇产科妊娠28～33+6周分娩的67例早发型重度子痫前期患者的临床资料,探讨围产儿预后及相关影响因素。结果 71例(双胎4例)围产儿中胎死宫内13例,治疗性引产过程中死产5例,新生儿重度窒息死亡8例,1例出生后4d因ARDS死亡,围产儿总死亡率380‰(27/71);新生儿出生缺陷发生率70%(5/71)。45例存活的新生儿中失访11例,34例新生儿随访1个月～6年,1例产后10d死亡,1例产后1+个月发现脑瘫,31例新生儿后期发育未见明显异常。影响围产儿死亡的相关因素:新生儿出生体重(P=0.000)、分娩孕周(P=0.001)、规律产检(P=0.03)、期待治疗的天数(P=0.04);与胎死宫内明显相关的因素为胎盘早剥(P=0.037)、严重FGR(P=0.001)。与围产儿死亡不相关的因素:孕妇年龄、产次、体重指数、平均动脉压、24h尿蛋白。结论早发型重度子痫前期孕妇围产儿死亡率较高,母体严重并发症和孕周是影响围产儿死亡的主要因素,加强围产期保健、积极防治并发症、适时终止妊娠可改善围产儿预后。Objective The purpose of this study was to determine the perinatal outcomes and risk factors for perinatal mortality in severe preeclampsia women between 28～33＋6weeks＇ gestation.Methods Data of 67 women（71 fetuses）with severe preeclampsia occurred in 28 to 33＋6weeks who delivered at Beijing Friendship Hospital from December 2003 to March 2010 was analyzed retrospectively.Results The perinatal mortality rate was 380‰（27/71）with 13 intrauterine death,5 stillbirth,8 neonatal death due to severe asphyxia and 1neonatal death due to ARDS.Fetal birth defect rate was 70‰（5/71）,three were spina bifida and one was hypospadias.Thirty-four newborn infants were under follow-up from 1 to 72 months.One infant was dead 10 days after birth.One showed cerebral palsy thirty days after birth.Thirty-one infants developed normally after long-time follow-up.Logistic regression analysis showed that fetal gestation age（P=0.000）,newborn weight（P=0.001）,regular antennal care（P=0.03）and delay treatment（P=0.04）were risk factors related to prenatal mortality.Placenta abruption（P=0.037）and severe FGR（P=0.001）significantly increased the risk of fetal intrauterine death.Conclusions Severe maternal complications and gestational age are the main risk factors related to perinatal mortality.Expectant management in appropriate patients in the tertiary care center with close maternal and fetal monitoring would improve the prenatal outcomes.

关 键 词：早发型重度子痫前期 围产儿预后 影响因素 

分 类 号：R714.7[医药卫生—妇产科学]