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目的 探讨重度妊娠高血压综合征 (妊高征 )适宜的终止妊娠时机和分娩方式。方法 回顾分析 114例重度妊高征患者的临床资料 ,比较不同孕周终止妊娠及阴道分娩与剖宫产之间的母婴结局。结果 ≤ 32周分娩的新生儿窒息率、围生儿病死率明显升高 (P <0 .0 1) ,33～ 36周与≥ 37周无显著性差异(P >0 .0 5 )。各孕周间的孕产妇并发症发生率无显著性差异 (P >0 .0 5 )。与剖宫产组比较 ,阴道分娩组分娩孕周及新生儿出生体重显著降低 ,其围生儿病死率及孕产妇并发症均显著升高 ,差异有显著性 (P <0 .0 1)。剖宫产与阴道分娩的新生儿窒息率无显著性差异 (P >0 .0 5 )。结论 重度妊高征患者如病情需要 ,在促胎肺成熟治疗后可于孕 32周终止妊娠 ,分娩方式以剖宫产为佳。
Objective To investigate the appropriate timing of termination of pregnancy and mode of delivery in patients with severe pregnancy-induced hypertension (PIH). Methods The clinical data of 114 patients with severe PIH were retrospectively analyzed. The maternal and infant outcomes between different pregnancy gestations and vaginal delivery and cesarean section were compared. Results Neonatal asphyxia at delivery ≤ 32 weeks had significantly higher perinatal mortality (P <0. 01), no significant difference between 33 and 36 weeks and ≥ 37 weeks (P> 0.05). There was no significant difference in the incidence of maternal complications among the gestational weeks (P> 0.05). Compared with the cesarean section group, vaginal delivery components gestational weeks and neonatal birth weight was significantly reduced, and its perinatal mortality and maternal complications were significantly increased, the difference was significant (P <0.01). There was no significant difference in neonatal asphyxia between cesarean section and vaginal delivery (P> 0.05). Conclusions Patients with severe PIH need to be cesarean at the age of 32 weeks after maturation of fetal lung.