2812例重度子痫前期母儿并发症分析  

Analysis of maternal and neonatal outcomes in 2812 patients with severe preeclampsia

作　　者：伍绍文[1] 张为远[1] 王琪[1] 刘晓巍[1] 

机构地区：[1]首都医科大学附属北京妇产医院产科,北京100026

出　　处：《中国医药导报》2015年第33期128-131,共4页China Medical Herald

基　　金：首都卫生发展科研专项项目(首发2011-2011-01);首都医科大学附属北京妇产医院中青年学科骨干培养专项(fcyy201414)

摘　　要：目的 探讨不同孕龄重度子痫前期母儿并发症发生情况。方法 选取2002年1月~2012年12月在首都医科大学附属北京妇产医院住院分娩的重度子痫前期孕妇2812例,按照入院孕龄将其分为4组：Ⅰ组（孕龄≤27＋6周）207例,Ⅱ组（孕龄28~33＋6周）548例,Ⅲ组（孕龄34~36＋6周）584例,Ⅳ组（孕龄≥37周）1473例,比较各组孕产妇及围生儿并发症发生情况。结果 1孕产妇并发症比较：2812例孕妇中,心衰21例（0.75%）,胎盘早剥92例（3.27%）,子痫33例（1.17%）,肾功能衰竭2例（0.07%）,凝血功能障碍18例（0.64%）,无孕产妇死亡。四组胎盘早剥发生率比较差异有统计学意义（P〈0.05）;Ⅰ、Ⅱ组的胎盘早剥率明显高于Ⅲ组（P〈0.01）,Ⅲ组明显高于Ⅳ组（P〈0.01）。四组子痫的发病率比较差异无统计学意义（P〉0.05）。入院孕龄〈34周孕妇心衰及凝血功能障碍发生率明显高孕龄≥34周孕妇（P〈0.05）。将数据合并后发现入院孕龄〈34周孕妇心衰[1.85%（14/755）]及凝血功能障碍发生率[1.72%（13/755）]明显高于孕龄≥34周的孕妇[0.34%（7/2057）、0.24%（5/2057）],差异均有统计学意义（P〈0.05）。2新生儿并发症比较：2812例新生儿中,胎儿窘迫发生率为16.1%,小于胎龄儿发生率为12.2%,新生儿窒息发生率为6.3%,围生儿死亡率为4.2%。四组间胎儿窘迫发生率、小于胎龄儿发生率、新生儿窒息发生率及围生儿死亡率比较差异均有统计学意义（P〈0.05）。孕龄越小,围生儿并发症发生率越高。结论 不同孕龄重度子痫前期的子痫发生率相似,发病于34周之前的患者胎盘早剥发生率最高。孕龄越小,围生儿并发症发生率越高。Objective To analyze the maternal and perinatal outcomes in 2812 patients with severe preeclampsia in different gestational weeks. Methods 2812 cases who were diagnosed with severe preeclampsia and delivered in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2002 to December 2010 were divided into 4 groups according to gestation weeks when admission, including group Ⅰ （gestation week less than 27＋6 weeks） 207 cases, group Ⅱ （gestation weeks between 28 and 33＋6 weeks） 548 cases, group Ⅲ （gestation weeks between 34 and 36＋6 weeks） 584 eases, group Ⅳ （gestation weeks longer than 37 weeks） 1473 cases. The maternal and neonatal ＇complications were respectively compared among the four groups. Results （1）The maternal complications： 21 cases （0.75%） occurred heart failure, 92 cases （3.27%） occurred placental abruption, 33 cases （1.17%） occurred eclampsia, 2 cases （0.07%） occurred renal failure, 18 cases （0.64%） occurred blood coagulation dysfunction and no maternal death occurred among those cases. There was significant difference in the incidence of placental abruption among the four groups （P 〈 0.05）. The incidence of placental abruption in group Ⅰ and group Ⅱ were significantly higher than that in group Ⅲ （P 〈 0.01）, the incidence of placental abruption in group m was significantly higher than that in group Ⅳ （P 〈 0.01）. The rate of eclampsia between the four groups was almost the same. The incidence of heart failure [1.85% （14/755）] and blood coagulation dysfunction [1.72% （13/755）] in the patients whose gestational week 〈 34 weeks when admission were obviously higher than those gestational week ≥ 34 weeks [0.34% （7/2057）, 0.24% （5/2057）] after merging the dates （P 〈 0.05）. （2）Neonatal complications： the incidence of fetal distress was 16.1%, the incidence of SGA was 12.2%, the neonatal asphyxia was 6.3% and the perinatal mortality rate was 4.2%. There were significan

关 键 词：重度子痫前期 孕产妇 围生儿 并发症 

分 类 号：R714.245[医药卫生—妇产科学]