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目的探讨妊娠期高血压疾病的治疗、终止妊娠的时机和分娩方式及如何降低妊娠期高血压疾病的发生率和降低母婴病死率。方法 116例妊娠期高血压疾病患者,年龄20～40岁,给予25%的硫酸镁静脉滴注,控制血压至140～150/90～100 mm Hg(1 mm Hg=0.133 kPa)。监测孕妇及胎儿状况。结果妊娠期高血压20例,子痫前期轻度50例,子痫前期重度40例,子痫6例。阴道分娩30例,剖宫产86例。产后出血7例,产妇死亡1例,新生儿窒息12例,死亡9例。剖宫产率74.1%,阴道分娩率25.9%;新生儿窒息率10.3%,围生儿死亡率7.8%。结论妊娠期高血压、子痫前期轻度经过观察及治疗,可以经阴道试产,子痫前期重度及子痫患者最基本的处理原则是适时终止妊娠,适时终止妊娠是保证母亲安全和提高新生儿存活率的重要措施,而剖宫产是终止妊娠的主要方法。
Objective To investigate the treatment of hypertensive disorder complicating pregnancy, the timing of termination of pregnancy and mode of delivery and how to reduce the incidence of hypertensive disorders during pregnancy and reduce the maternal and infant mortality. Methods One hundred and sixteen patients with gestational hypertension were aged 20-40 years old. They were given intravenous infusion of 25% magnesium sulfate and the blood pressure was controlled to 140-150/90 to 100 mm Hg (1 mm Hg = 0.133 kPa). Monitoring of pregnant women and fetus status. Results 20 cases of gestational hypertension, mild preeclampsia 50 cases, severe preeclampsia 40 cases, 6 cases of eclampsia. Vaginal delivery in 30 cases, 86 cases of cesarean section. Postpartum hemorrhage in 7 cases, maternal death in 1 case, neonatal asphyxia in 12 cases, 9 cases of death. Cesarean section rate was 74.1% and vaginal delivery rate was 25.9%. Neonatal asphyxia rate was 10.3% and perinatal mortality rate was 7.8%. Conclusions Gestational hypertension and mild preeclampsia may be treated by vaginal trial. The most basic treatment principle for patients with severe preeclampsia and eclampsia is timely termination of pregnancy. Timely termination of pregnancy is necessary to ensure mothers’ safety and improve freshmen’s health Child survival rate of important measures, and cesarean section is the main method of termination of pregnancy.