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目的:探讨早发型及晚发型重度子痫前期的临床特点及围产结局。方法:回顾性分析东南大学附属江阴医院产科2010年1月至2012年2月收治的重度子痫前期80例患者的临床资料,将其分为早发型重度子痫前期组(早发型组,妊娠<34周,20例)和晚发型重度子痫前期组(晚发型组,妊娠≥34周,60例)。结果:孕产妇并发症早发型组高于晚发型组,终止妊娠的孕周早于晚发型组,终止妊娠的方式剖宫产率高于晚发型组,差异均具有统计学意义(P<0.05);胎儿窘迫、死胎、胎儿生长受限、新生儿窒息、新生儿死亡等发生率早发型组显著高于晚发型组(P<0.01)。结论:早发型重度子痫前期严重影响母婴预后,适当期限的期待治疗有助于改善母婴结局,剖宫产是终止重度子痫前期的主要方法。
Objective: To investigate the clinical features and perinatal outcome of early-onset and late-onset severe preeclampsia. Methods: The clinical data of 80 patients with severe preeclampsia admitted from January 2010 to February 2012 in Jiangyin Hospital Affiliated to Southeast University were retrospectively analyzed and divided into early-onset severe preeclampsia group (early-onset group, pregnancy <34 weeks, 20 cases) and late-onset severe preeclampsia group (late-onset group, pregnancy ≥34 weeks, 60 cases). Results: The rate of cesarean section in the early-onset group was higher than that in the late-onset group, the gestational age was earlier than the late-onset group, and the cesarean section rate was higher in the termination of pregnancy than in the late-onset group (P <0.05) ). The incidences of fetal distress, stillbirth, fetal growth restriction, neonatal asphyxia and neonatal death were significantly higher in early-onset group than in late-onset group (P <0.01). Conclusion: Premature onset severe preeclampsia has a serious impact on the prognosis of maternal and infant. Expecting treatment for the appropriate period will help to improve maternal and infant outcomes. Cesarean section is the main method to terminate severe preeclampsia.