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  

Maternal and Perinatal Outcomes during Expectant Management of Early-Onset Severe Preeclampsia with Fetal Growth Restriction

作　　者：周颖[1] 汪燕[1] 邱娜璇[1] 

机构地区：[1]厦门大学附属第一医院,福建厦门361003

出　　处：《实用妇产科杂志》2015年第3期221-224,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨期待治疗中早发型重度子痫前期合并胎儿生长受限（FGR）的母儿结局，为临床处理提供依据。方法：回顾性分析2002年1月至2012年12月厦门大学附属第一医院产科收治的早发型重度子痫前期患者143例的临床资料，其中合并FGR48例（合并FGR组），未合并FGR95例（未合并FGR组）。比较两组一般情况、孕产妇并发症、分娩情况和新生儿情况及143例患者不同分娩孕周（〈孕30周、孕30～3l^＋6周、≥孕32周）围生儿结局。结果：①两组一般情况、期待治疗平均延长孕周和孕产妇并发症（HELLP综合征、子痫、胎盘早剥、心衰等）的发生率比较，差异均无统计学意义（P〉0．05）。②合并FGR组分娩孕周晚于未合并FGR组（P〈0．05），但其新生儿出生体重小于未合并FGR组（P〈0．05）。合并FGR组围生儿死亡率高于未合并FGR组（P〈0．05）。③新生儿并发症中，合并FGR组心脏发育不全的发生率高于未合并FGR组（P〈0．05）。④随着分娩孕周增加，早发型重度子痫前期患者的围生儿死亡率和新生儿肺透明膜病的发生率逐渐降低，差异均有统计学意义（P〈0．05）。合并FGR围生儿死亡率和总体心脏发育不全的发生率在分娩孕周≥32周后也明显降低（P〈0．05）。结论：对于早发型重度子痫前期合并FGR的患者，期待治疗并不增加孕产妇并发症。合并FGR的患儿心脏发育不全发生率及围生儿死亡率明显增加，但期待治疗后通过延长孕周可改善其围生儿结局。Objective：To discuss the maternal and perinatal outcomes of early-onset severe preeclampsia with fetal growth restriction with expectant management. Methods：Retrospective analysis of the clinical data of 143 cases with early-onset severe preeclampsia from the years 2002 to 2012 in our hospital,including 48 cases com- plicated with fetal growth restriction （FGR） （ FGR group ） and 95 cases not complicated with FGR （ non-FGR group）. Results：①There was no difference in maternal complications between two groups, including H ELLP syn- drome, eclampsia, abruption placentae. ②Although the gestational week of the FGR group was longer than that of non-FGR group（ P 〈 0. 05）, the birth weight was lower, and the prenatal mortality was higher than non-FGR group. ③ln neonatal complications, the incidence of heart dysgenesis in FGR group was higher than that in non-FGR group（P〈0.05）. ④The incidence of prenatal mortality and incidence of respiratory distress syndrome decreased according to the increase of gestational week. When gestational week≥32 ,the prenatal mortality and incidence of heart dysgenes of FGR group decreased significantly. Conclusions： Expectant management for ear- ly-onset severe preeclampsia with fetal growth restriction didn＇t increase the incidence of maternal complications. The prenatal mortality in FGR group was higher, but the prenatal outcomes can be improved by prolonging of ges- rational week.

关 键 词：早发型重度子痫前期 胎儿生长受限 期待治疗 

分 类 号：R714.244[医药卫生—妇产科学]