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目的探索期待治疗中早发型重度子痫前期合并胎儿生长受限(FGR)的母儿结局。方法选择2009年1月-2015年1月在该院产科进行期待治疗的97例早发型重度子痫前期患者为研究对象,其中合并FGR者38例(研究组),未合并FGR者59例(对照组),回顾性分析两组患者临床资料,对比两组母儿结局。结果两组孕产妇子痫、胎盘早剥、HELLP综合征、心衰及血小板减少发生率比较,差异均无统计学意义(P>0.05)。两组孕产妇剖宫产率和产后出血率比较,差异均无统计学意义(P>0.05);研究组早产率较对照组明显增加(P<0.05),终止妊娠时间较对照组明显缩短(P<0.05)。两组新生儿黄疸发生率比较,差异无统计学意义(P>0.05);研究组新生儿窒息、肺透明膜病变、心脏发育不全、新生儿贫血及新生儿死亡发生率均较对照组明显增加(P<0.05)。结论期待治疗不会增加早发型重度子痫前期合并FGR孕产妇并发症的发生率,且能改善其分娩结局和新生儿结局,因此,尽早发现、积极预防并适时终止妊娠,对改善母婴预后具有重要意义。
Objective To explore the maternal and infant outcomes of expectant treatment of early-onset severe preeclampsia with fetal growth restriction (FGR). Methods Ninety-seven patients with early-onset severe preeclampsia who were expectantly treated in our hospital from January 2009 to January 2015 were enrolled. Among them, 38 patients with FGR (study group), 59 patients without FGR Control group), retrospectively analyzed the clinical data of two groups of patients, comparing two groups of maternal and child outcomes. Results There was no significant difference in incidence of maternal preeclampsia, placental abruption, HELLP syndrome, heart failure and thrombocytopenia between the two groups (P> 0.05). There was no significant difference between the two groups in the rate of cesarean section and the rate of postpartum hemorrhage (P> 0.05). The preterm birth rate in the study group was significantly higher than that in the control group (P <0.05), and the termination of pregnancy was significantly shorter than that in the control group P <0.05). There was no significant difference in incidence of neonatal jaundice between the two groups (P> 0.05). The incidence of neonatal asphyxia, hyaline membrane disease, cardiac hypoplasia, neonatal anemia and neonatal death in study group were significantly higher than those in control group (P <0.05). Conclusion Expecting treatment will not increase the incidence of maternal complications in patients with early-onset severe preeclampsia and FGR, and may improve the outcome of delivery and neonatal outcome. Therefore, early detection, active prevention and timely termination of pregnancy may have an impact on improving maternal and infant prognosis It is of great significance.