早发型重度子痫前期的保守治疗及临床结局

目的探讨早发型重度子痫前期保守治疗时限及妊娠结局。方法60例无严重并发症及合并症的早发型重度子痫前期患者，按其发病孕周分为3组，A组（〈28周）14例，B组（28～31^＋6周）27例，C组（32～33^＋6周）19例。分析3组孕期治疗时限、孕妇并发症、胎儿及围产儿结局。结果A、B、C组保守治疗时间分别为（8．4±6．6）、（10．3±7．2）、（9．2±6．2）d，3组比较差异无统计学意义（P〉0．05）；C组孕妇并发症低于A、B组（P〈0．05）；胎儿及新生儿死亡率C组明显低于A、B组（P〈0．01）。结论早发型重度子痫前期保守治疗可行，但需严密监测母儿情况，适时终止妊娠。发病孕周越晚，孕妇并发症越少，围产儿成活率越高。

Study of Expectant Management and Pregnancy Outcome of Early Onset Severe Pre-edampsia

Objective To explore the clinical features of 60 cases of early onset severe preeclampsia （S-PE）and to investigate expectant management and pregnancy outcome with them. Methods Sixty cases meeting the criteria of early onset severe preeclampsia who underwent expectant management were enrolled in this study. Patients were divided into group A（n= 14）with onset before 28 weeks of gestation, group B（n= 27）with onset during 28-31^＋6 weeks of gestation,group C（n=19）with onset during 32-33^＋6 gestational weeks. The clinical data were evaluated. Analytic index included prolongation of gestations and maternal outcomes and prenatal mortality and morbidities. Results The average pregnancy prolongations of group A were （8.4±6.6） days,contrasted to （10. 3±7.2） days in group B and （9.2±6.2）days in group C. Three were no differences with the average pregnancy prolongations in the groups A,B and C（P〉 0.05）. While in the group C, the rate of maternal complications was lower than that of in the groups A and B（P〈0.05）and the fatal and new born death was lower than that of in the groups A and B （P〈 0.01）. There was not a significant difference of maternal complications between groups A and B. Conclusion It is feasible for expectant managrment of early onset of severe preeclasmpsia under intensive care and appropriarely selected cases. The perinatal outcome is associated with the onset time of severe preeclampsia.