早发型重度子痫前期期待治疗再评价

目的探讨早发型重度子痫前期期待治疗对母儿结局的影响。方法回顾性分析73例早发型重度子痫前期病例,按入院后终止妊娠孕周分为3组,A组,孕周≤32周;B组,32周<孕周≤34周;C组,孕周>34周。根据期待治疗时间分为3组,Ⅰ组,治疗时间≤48小时;Ⅱ组,治疗时间:3~9 d;Ⅲ组,治疗时间>9 d。比较终止妊娠孕周及期待治疗时间与妊娠结局的关系。结果期待治疗过程中患者原有并发症加重或发生新的并发症的发生率以Ⅲ组最高。早发型重度子痫前期终止妊娠孕周越早,新生儿死亡率越高,新生儿死亡率随着期待治疗时间的延长显著降低(P<0.05)。新生儿窒息率以Ⅱ组最低。结论早发型重度子痫前期严重威胁母儿预后,严密监测进行期待治疗可明显改善围生儿结局,合适的期待治疗时间起着重要作用。

Study on the expectant management of early onset severe pre-eclampsia

Objective To investigate the effect of the expectant management on the maternal and neonatal outcome in early onset severe pre-eclampsia.Methods Retrospective analysis of 73 patients with early onset severe pre-eclampsia from 2004 to 2009 was performed.The patients were divided into three groups according to gestational age at delivery：group A（≤32 weeks）,group B（32-34 weeks）,and group C（〉34 weeks）,and were also divided into another three groups according to period of expectant management：group Ⅰ（less than 48 h）,group Ⅱ（3-9 days） and group Ⅲ（more than 9 days）.The relationship between the gestational week of termination and period of expectant management and pregnancy outcome was compared.Results The incidence rates of deterioration of original complications or secondary complication were highest in group Ⅲ in period of expectant management.The smaller the gestational weeks of termination in early onset severe pre-eclampsia,the higher the neonatal mortality rates.The neonatal mortality rates obviously declined with the prolongation of treatment time（P〈0.05）.In addition,the rate of neonatal asphyxia was lowest in group Ⅱ.Conclusions The early onset severe pre-eclampsia seriously affects the maternal and neonatal outcome.The expectant management benefits perinatal outcome,in which the suitable duration of treatment plays an important role.