早发型重度子痫前期101例临床分析  

The Clinical Features of 101 Cases with Early-Onset Severe Preeclampsia

作　　者：岳军[1] 梅立[1] 谢兰[1] 

机构地区：[1]四川省医学科学院四川省人民医院,四川成都610072

出　　处：《实用妇产科杂志》2013年第1期63-66,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨早发型重度子痫前期的临床特征及对妊娠结局的影响。方法:回顾性分析我院收治的289例重度子痫前期病例(其中早发型组101例,晚发型组188例,围生儿301例)的母婴结局。结果:①早发型组的发病时平均血压、发病孕周、分娩孕周及严重并发症发生率与晚发型组比较,差异有统计学意义(P<0.05);两组分娩方式比较,差异无统计学意义(P>0.05);且早发型组胎儿脐血流比值(S/D)、胎儿生长受限(FGR)、早产、胎儿窘迫、新生儿窒息、围生儿死亡的发生率高于晚发型组,差异有统计学意义(P<0.05);②早发型重度子痫前期按发病孕周分为A组(<28周)、B组(28～31+6周)、C组(32～33+6周),3组围生儿结局比较,A组病例中胎儿脐动脉S/D≥3、FGR及新生儿窒息的发生率均高于B组及C组(P<0.05);而A组及B组围生儿死亡率高于C组,差异有统计学意义(P<0.05);③早发型重度子痫前期病例中脐动脉S/D≥3的病例,FGR、胎儿窘迫、新生儿窒息及围生儿死亡的发生率均高于S/D<3的病例(P<0.05);两者间早产的发生率差异无统计学意义(P>0.05)。结论:早发型重度子痫前期孕妇发病孕周越早,FGR、新生儿窒息、胎儿窘迫及围生儿死亡发生率越高,围生儿结局不佳。基层医院应加强孕期保健,定期行产前检查。Objective.To explore the effect of early-onset severe preeclampsia on the mother and neonatals.Methods：289 severe preeciampsia mothers and their 301 neonatais were retrospectively analyzed. Test group included 101 cases with early-onset preeclampsia （onset before 34 gestational weeks） and control group included 188 cases with late-onset preeclampsia （onset after 34 gestation weeks）. 101 patients with early-onset severe preeclampsia were divided into three groups according to gestational weeks on admis- sion： A group （ gestational weeks ≤27 ＋6 weeks）, B group （28 weeks 〈 gestational weeks ≤31 ＋6 weeks）, C group （32 weeks 〈 gestational weeks≤33＋6 weeks）. The relationship between different gestational weeks/ treatment times and maternal and fetal outcomes, and perinatal outcomes were compared. Results：①The in- cidence of maternal complications, gestational weeks, fetal growth restriction, fetal intrauterine distress, neo- natal asphyxia and neonatal death in early onset group were significantly higher than those in the late onset group （ P 〈 0.05）, and the mode of delivery between two groups had no difference （ P 〉 0. 05）. ②The inci- dences of maternal complications,intrauterine fetal death, neonatal asphyxia and neonatal death in A group were significantly higher than those in both B and C group （ P〈0. 05）. ③The incidence of intrauterine growth restriction （FGR）,fetal intrauterine distress, neonatal asphyxia and neonatal death diagnosed by ultrasound examination, color Doppler parameters of umbilical artery systolic, diastolic flow velocity ratio （ S/D ≥3） differ- ence between the two groups had significant difference （P 〈 0. 05）. Conclusions：The earlier occurrence of early-onset severe preeclampsia, the higher incidence of maternal and neonatal complications is, which af- fects maternal and neonatal outcomes. On the basis of comprehensive monitoring, expectant management can improve the perinatal outcomes significantly,which don＇

关 键 词：早发型重度子痫前期 妊娠并发症 围生儿预后 

分 类 号：R714.244[医药卫生—妇产科学]