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目的:探讨早发型重度子痫前期(S-PE)的发生时间对孕妇和围产儿的影响。方法:对该院收住院的116例S-PE患者,根据发病的时间分成两组,A组:≤孕32周,为早期S-PE 52例,B组:孕32+1～34周,为晚期S-PE 64例,回顾分析两组的临床经过、孕妇并发症和围产儿结局。结果:从发病到住院时间A组(12.6±17.6)天略短于B组(16.3±16.5)天,两组比较差异无统计学意义(P>0.05)。比较两组并发症,肾病综合征(32.69%VS 6.25%);胎盘早剥(28.85%VS 7.81%);胎儿生长受限(FGR)(48.08%VS 23.44%);肝脏损伤(26.92%VS 12.50%),A组孕妇的并发症明显高于B组,两组比较差异有统计学意义(P<0.05或P<0.01)。HELLP综合征(15.38%VS 4.69%),两组比较差异有统计学意义(χ2=3.82,P<0.05)。A组小胎盘发生率明显高于B组(23.08%VS 9.38%),两组比较差异有统计学意义(P<0.05)。A组围产儿死亡率明显高于B组(21.15%VS 1.56%),两组比较差异有统计学意义(P<0.01)。A组新生儿窒息高于B组(17.31%VS 7.81%),但差异无统计学意义(P>0.05)。结论:S-PE的发病时间越早,孕妇并发症越多,围产儿预后越差。早期认识,早期诊断早期S-PE,积极期待治疗可以改善母儿结局。
Objective: To investigate the impact of early onset severe preeclampsia (S-PE) on pregnant women and perinatals. Methods: One hundred and sixty-six patients with S-PE admitted to the hospital were divided into two groups according to the time of onset. Group A: ≤ 32 weeks of pregnancy, 52 cases of early S-PE, Group B: 32 + 1-34 weeks of pregnancy, 64 cases of advanced S-PE, a retrospective analysis of the clinical course of the two groups, complications of pregnant women and perinatal outcomes. Results: The days from onset to hospitalization in group A (12.6 ± 17.6) were slightly shorter than those in group B (16.3 ± 16.5) days, with no significant difference between the two groups (P> 0.05). Nephrotic syndrome (32.69% VS 6.25%), placental abruption (28.85% VS 7.81%), FGR (48.08% VS 23.44%) and liver injury (26.92% VS 12.50 %). The complications of pregnant women in group A were significantly higher than those in group B, the difference was statistically significant (P <0.05 or P <0.01). HELLP syndrome (15.38% VS 4.69%), the difference between the two groups was statistically significant (χ2 = 3.82, P <0.05). The incidence of placenta in group A was significantly higher than that in group B (23.08% VS 9.38%). There was significant difference between the two groups (P <0.05). The perinatal mortality rate in group A was significantly higher than that in group B (21.15% VS 1.56%). There was significant difference between the two groups (P <0.01). The neonatal asphyxia in group A was higher than that in group B (17.31% VS 7.81%), but the difference was not statistically significant (P> 0.05). Conclusion: The earlier the onset of S-PE, the more complications of pregnant women, the worse the prognosis of perinatal. Early recognition, early diagnosis of early S-PE, positive expectant treatment can improve maternal and child outcomes.