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目的探讨孕32周前发生的妊娠期高血压疾病的临床特点及预后。方法孕32周前发生的妊娠期高血压30例,轻度子痫前期30例,重度子痫前期30例,以孕32周以后发生的妊娠期高血压疾病90例作为相应的对照组。结果妊娠期高血压、轻度子痫前期分别有66.7%、76.7%发展成重度子痫前期,三组严重并发症:子痫、心衰、肾功能衰竭、DIC、HELLP综合征、眼底出血、胎盘早剥的总发生率分别是13.3%、40%、60%,均比相应的对照组高(P<0.05);胸腹水、低蛋白血症、24 h尿蛋白定量>5 g、血小板减少、血黏度增高的发生率均比相应的对照组高(P<0.05)。胎儿生长受限CFGR的发生率分别是13.3%、43.3%、56.7%,FGR总发生率为37.8%,与对照组比较,FGR的总发生率明显升高(P<0.05),围产儿死亡率分别是20%、53.3%、86.7%,均比相应的对照组高(P<0.01)。结论发生在孕32周以前的妊娠期高血压疾病的母儿结局不良,早期诊断和治疗,开展预测和预防是改善母儿预后的关键。
Objective To investigate the clinical features and prognosis of gestational hypertension (Hypertension) occurring 32 weeks before pregnancy. Methods 30 cases of gestational hypertension occurred in 32 weeks before pregnancy, 30 cases of mild preeclampsia and 30 cases of severe preeclampsia. 90 cases of hypertensive disorders of pregnancy after 32 weeks of pregnancy were taken as the corresponding control group. Results In gestational hypertension and mild preeclampsia, 66.7% and 76.7% developed severe preeclampsia. Three serious complications were eclampsia, heart failure, renal failure, DIC, HELLP syndrome, fundus hemorrhage, The overall incidence of placental abruption was 13.3%, 40%, 60%, respectively, than the corresponding control group (P <0.05); pleural effusion, hypoproteinemia, 24 h urinary protein quantification> 5 g, thrombocytopenia , The incidence of increased blood viscosity were higher than the corresponding control group (P <0.05). Fetal growth restriction CFGR incidence rates were 13.3%, 43.3%, 56.7%, FGR overall incidence was 37.8%, compared with the control group, the incidence of FGR was significantly increased (P <0.05), perinatal mortality Respectively, 20%, 53.3% and 86.7%, respectively, than the corresponding control group (P <0.01). Conclusion Maternal and neonatal outcomes of gestational hypertension before 32 gestational weeks are poor, early diagnosis and treatment, and prediction and prevention are the keys to improve the prognosis of pregnant women.