早发型重度子痫前期不同终止妊娠时机的预后对比分析  

Comparison of prognosis of different pregnancy termination timing in early onset severe preeclampsia

作　　者：蒋玲祥[1] 夏桂玉[1] JIANG Lingxiang;XIA Guiyu(Department of Obstetrics, Shaoxing Maternal and Child Health Hospital, Shaoxing 312000, China)

机构地区：[1]浙江省绍兴市妇幼保健院产科,浙江绍兴312000

出　　处：《中国现代医生》2018年第4期68-71,共4页China Modern Doctor

基　　金：浙江省自然科学基金青年项目(LQ15H040001)

摘　　要：目的探讨早发型重度子痫前期不同终止妊娠时机的预后效果。方法选择2015年1月~2017年5月在我院接受治疗的120例早发型重度子痫前期的患者,根据终止妊娠时孕周不同将所有患者分为三组,分别为终止妊娠<32周(A组)、终止妊娠为32~33+6周(B组)、终止妊娠≥34周(C组),每组各40例。调查并统计三组孕产妇并发症以及围产儿结局、分娩方式。结果三组胎盘早剥、产后出血、低蛋白血症、酮症酸中毒发生率比较,差异无统计学意义(P>0.05);A组胎盘粘连、植入和HELLP发生率高于B组、C组,差异具有统计学意义(P<0.05);B组、C组胎盘粘连、植入和HELLP发生率比较,差异无统计学意义(P>0.05);三组胎儿窘迫、胎死宫内发生率比较,差异无统计学意义(P>0.05);A组围产儿死亡和新生儿窒息率高于B组、C组,差异具有统计学意义(P<0.05);B组、C组围产儿死亡和新生儿窒息发生率比较,差异无统计学意义(P>0.05);A组剖宫产率低于B组、C组,差异具有统计学意义(P<0.05);B组、C组剖宫产率比较,差异无统计学意义(P>0.05)。结论早发型重度子痫前期患者在妊娠34周后终止妊娠能降低孕妇并发症发生率和围产儿死亡、新生儿窒息率,母婴结局较好,剖宫产是其重要终止妊娠手段。Objective To investigate the prognostic effects of different pregnancy termination timing in early onset severe preeclampsia.Methods120patients with early onset severe preeclampsia treated in our hospital from January2015to May2017were selected,and they were divided into termination of gestational weeks<32weeks(A group),32weeks<termination of gestational weeks<33+6weeks(B group)and termination of gestational weeks≥34weeks(C group)by different pregnancy termination timing,40cases in each group.The maternal complications,perinatal outcome and delivery mode of three groups were compared.Results There was no statistical difference in the incidence of placental abruption,postpartum hemorrhage,hypoproteinemia,ketoacidosis among the three groups(P>0.05);The incidence of placenta adherence,implantation,HELLP in A group was higher than that in B and C group(P<0.05);There was no statistical difference in the incidence of placenta adherence,implantation,HELLP between B and C group(P>0.05);There was no statistical difference in the incidence of fetal distress and intrauterine death among the three groups(P>0.05),the incidence of perinatal death and neonatal asphyxia in A group was higher than that in B and C group(P<0.05),and there was no statistical difference in the incidence of perinatal death and neonatal asphyxia between B and C group(P>0.05);The cesarean section rate of A group was lower than that of B and C group(P<0.05),and there was no statistical difference in the cesarean section rate between B and C group(P>0.05).Conclusion The termination of gestational weeks after34weeks in early onset severe preeclampsia can decrease the incidence of maternal complications,perinatal death and neonatal asphyxia,achieve better mother-infant prognosis.The cesarean section is important method of pregnancy termination.

关 键 词：早发型重度子痫前期 终止妊娠时机 产儿结局 孕产妇并发症 

分 类 号：R714.2[医药卫生—妇产科学]