早发型子痫前期的围生期结局分析

对本院收治的96例重度子痫前期患者进行分析,报告如下.1 资料与方法1.1 一般资料:96例重度子痫前期患者共有围生儿103例.按照发病孕周分成两组:≤32周为早发型重度子痫前期[1](EOSP)组,共50例;＞32周为晚发型重度子痫前期(LOSP)组,共46例.     

微波辐射治疗子宫内膜疾患对卵巢功能的影响

目的：探讨微波治疗妇科疾患时对卵巢功能的影响。方法：观察不同剂量的微波辐射卵巢激素及辅助指标的变化。结果：一定量的微波对卵巢功能无影响，增大微波能量时，卵巢功能的激素呈下降波动。结论：治疗子宫内膜疾患时的微波辐射量对卵巢功能无影响，增大辐射量时对卵巢功能有一定影响，临床应予适当的卵巢功能监测及必要的激素调节治疗。     

孕晚期养护手册

当精子与卵子成功拥抱后，一个新生命便开始在妈妈的子宫里安营扎寨了。在随后的40周内，我们的准妈妈们不仅要为胎宝宝的健康成长提供充足的养分，和谐的精神环境，还要应对，克服孕期的种种不适，孕育新生命本来就是一项复杂的工程！     

重度子痫前期并发胎盘早剥46例临床分析

目的:探讨重度子痫前期并发胎盘早剥患者的临床特征及母婴预后。方法:以重度子痫前期并发胎盘早剥46例为观察组,同期重度子痫前期未并发胎盘早剥的383例为对照组,比较临床特征及母婴结局。结果:观察组分娩孕周(33.7±4.0)周明显小于对照组(35.6±3.8)周,差异有统计学意义(P<0.05)。观察组产前出血、强直宫缩、胎儿窘迫胎死宫内高于对照组,观察组白细胞、D-二聚体高于对照组,血红蛋白、血小板、纤维蛋白原低于对照组,观察组尿蛋白水平高于对照组,差异均有统计学意义(P<0.05),观察组出生低体重、新生儿窒息或死亡、子宫胎盘卒中、产后出血均高于对照组(P<0.05)。观察组中入院即诊断胎盘早剥者较入院后发现者早剥面积大、新生儿评分低、产后出血多,差异有统计学意义(P<0.05)。结论:早发型重度子痫前期患者较易发生胎盘早剥,重视胎盘早剥发生的早期临床表现,及时进行血常规、凝血功能、尿蛋白水平及B超检测,及时发现、早期处理胎盘早剥以改善母儿预后。     

重度子痫前期并发不良结局149例危险因素分析

Objective To explore clinical features of severe preeclampsia patients with adverse outcome, and the risk factors of adverse outcomes. Methods From Jan. 2008 to Dec. 2009 149 severepreeclampsia impatients who occurred adverse outcome enrolled as case,and 278 severe preeclampsia impatientswithout adverse outcome at the same period enrolled as control. The clinical features between the two groups were compared and the risk factors were investigated. Results No significant differences were found between the two groups in maternal age,times of previous prenancies. The gestation ages at the onset of preeclampsia and at delivery in the cases were less than controls(P ＜ 0. 05). There was significant difference in irregular antenatal checks between the two groups(x2 = 8. 515, P ＜ 0. 05). Proterinuria and the level of oedema in cases were higher than controls( P ＜ 0. 05). Fetal growth restriction (FGR) occurred more frequently in the cases (P ＜0. 05). Indirect bilirubin, total bilirubin, glutamic oxalacetic transaminase, glutamic pyruvic transaminase, uric acid, creatinine, white blood cell, thrombin time, D-dimeride of cases were higher than those of controls(Ps ＜0. 05). Albumin, platelet and profibrin of cases were lower than those of controls(Ps ＜ 0. 05 ＝. Multivariate logistic analysis showed that the gestation ages at the onset of preeclampsia, regular antenatal checks were significantly associated with adverse outcome(OR = 0. 899, P ＜ 0. 001; OR = 0. 600, P = 0. 022, respectively ＝Indirect bilirubin and D-dimeride were significantly associated with preeclampsia complications(OR = 1. 533,P =0. 010; OR = 1.001, P = 0. 003, respectively). Mean arterial pressure and creatinine were significantly associated with eyeground changes(respectively OR = 1. 030,P = 0. 048; OR = 1. 025, P = 0. 022, respectively).Regular antenatal checks was associated with dead fetus(OR = 0. 317, P = 0. 046). No significant differenceswere found between the two group in uterine-incision delivery(P ＞ 0. 05). Incidence rate of low birth weight infants and postpartum hemorrhage of cases were higher than controls and Apgar score was lower in cases than controls( all P ＜0. 05＝. Conclusion The gestation ages at the onset of preeclampsia,regular antenatal checks,fetal distress were risk factors for preeclampsia adverse outcome. Patients with.high indirect bilirubin and Ddimeride are more likely to suffer adverse pregnancy outcomes.     

重度子痫前期并发不良结局149例危险因素分析

目的 探讨重度子痫前期发生不良结局患者的临床特征及危险因素分析.方法 选择2008年1月至2009年12月在天津市第一中心医院住院的重度子痫前期并发不良结局149例为观察组,同期住院的重度子痫前期未发生不良结局278例为对照组,比较临床特征及分析不良结局的危险因素.结果 (1)一般资料:2组年龄、产次比较差异无统计学意义;观察组发病孕周、终止孕周均小于对照组差异均有统计学意义(P均＜0.05＝;观察组与对照组无规律产检率比较差异亦有统计学意义(x2=8.515,P=0.002).(2)临床特征及化验指标:观察组尿蛋白定性试验及水肿程度高于对照组,胎儿生长受限发生率更高,差异均有统计学意义(P均＜0.05＝.观察组间接胆红素、总胆红素、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、尿酸、肌酐、白细胞、凝血酶时间、D-二聚体均高于对照组;白蛋白、血小板及纤维蛋白原低于对照组,差异均有统计学意义(P均＜0.05＝.(3)影响因素分析:logistic多因素分析回归分析显示发病孕周、规律产检与子痫前期并发不良结局关系最大(分别为OR=0.899,P＜0.001;OR=0.600,P=0.022＝;各种化验指标中,间接胆红素及D-二聚体与子痫前期并发症关系最显著(分别为OR=1.533,P=0.010;OR=1.001,P=0.003).眼底病变与平均动脉压及肌酐水平关系最大(分别为OR=1.030,P=0.048;OR=1.025,P=0.022).胎死宫内与规律产检最大(OR=0.317,P=0.046).(4)母儿预后:2组剖宫产率差异无统计学意义(P＞0.05).观察组娩出低出生体重儿率高于对照组,观察组新生儿评分明显低于对照组;观察组产时出血高于对照组,差异均有统计学意义(P均＜0.05＝.结论 发病孕周过早、无规律产检及出现胎儿窘迫是子痫前期并发不良结局的高危因素.间接胆红素及D-二聚体增高应警惕子痫前期不良结局发生.

Abstract：

Objective To explore clinical features of severe preeclampsia patients with adverse outcome, and the risk factors of adverse outcomes. Methods From Jan. 2008 to Dec. 2009 149 severepreeclampsia impatients who occurred adverse outcome enrolled as case,and 278 severe preeclampsia impatientswithout adverse outcome at the same period enrolled as control. The clinical features between the two groups were compared and the risk factors were investigated. Results No significant differences were found between the two groups in maternal age,times of previous prenancies. The gestation ages at the onset of preeclampsia and at delivery in the cases were less than controls(P ＜ 0. 05). There was significant difference in irregular antenatal checks between the two groups(x2 = 8. 515, P ＜ 0. 05). Proterinuria and the level of oedema in cases were higher than controls( P ＜ 0. 05). Fetal growth restriction (FGR) occurred more frequently in the cases (P ＜0. 05). Indirect bilirubin, total bilirubin, glutamic oxalacetic transaminase, glutamic pyruvic transaminase, uric acid, creatinine, white blood cell, thrombin time, D-dimeride of cases were higher than those of controls(Ps ＜0. 05). Albumin, platelet and profibrin of cases were lower than those of controls(Ps ＜ 0. 05 ＝. Multivariate logistic analysis showed that the gestation ages at the onset of preeclampsia, regular antenatal checks were significantly associated with adverse outcome(OR = 0. 899, P ＜ 0. 001; OR = 0. 600, P = 0. 022, respectively ＝Indirect bilirubin and D-dimeride were significantly associated with preeclampsia complications(OR = 1. 533,P =0. 010; OR = 1.001, P = 0. 003, respectively). Mean arterial pressure and creatinine were significantly associated with eyeground changes(respectively OR = 1. 030,P = 0. 048; OR = 1. 025, P = 0. 022, respectively).Regular antenatal checks was associated with dead fetus(OR = 0. 317, P = 0. 046). No significant differenceswere found between the two group in uterine-incision delivery(P ＞ 0. 05). Incidence rate of low birth weight infants and postpartum hemorrhage of cases were higher than controls and Apgar score was lower in cases than controls( all P ＜0. 05＝. Conclusion The gestation ages at the onset of preeclampsia,regular antenatal checks,fetal distress were risk factors for preeclampsia adverse outcome. Patients with.high indirect bilirubin and Ddimeride are more likely to suffer adverse pregnancy outcomes.     

9例羊水栓塞的中西医结合抢救体会

９例羊水栓塞的中西医结合抢救体会王得玲李静徐凤琴作者单位：３００１９２天津市第一中心医院王得玲女４２岁主治医师羊水栓塞是由于羊水物质误入母体血循环而引起的一系列凶险病变的综合征，病死率高达８５％〔１〕，为孕产妇主要死亡原因之一。１９８５～１９９６年，...     

产科急性弥散性血管内凝血31例临床分析

产科弥散性血管内凝血(DIC)是孕产妇危重症之一.对31例产科DIC病例资料进行回顾性分析,报告如下. 1 临床资料 1.1 一般资料:2000-2008年在本院产科共发生DIC患者31例,占同期住院分娩总人数的0.251%.年龄20～37岁,平均29岁;初产妇14例,经产妇17例;孕周28～43周,平均37.6周;3例发生在产前,28例发生在产后;顺产6例,钳产1例,剖宫产24例.     

乙型肝炎病毒母婴传播阻断的临床研究现状

乙型肝炎病毒（HBV）母婴传播包括宫内感染、围产期传播及分娩后传播,母婴传播是慢性HBV感染的重要原因。我国的HBV携带者中40%～50%是通过母婴传播而来。阻断HBV母婴传播对控制HBV流行具有重要意义。近年来,大量学者在HBV的母婴传播方面做了大量工作,并取得了一定进展,现综述如下。     

孕中期养护手册

当精子与卵子成功拥抱后，一个新生命便开始在妈妈的子宫里安营扎寨了。在随后的40周内，我们的准妈妈们不仅要为胎宝宝的健康成长提供充足的养分，和谐的精神环境，还要应对、克服孕期的种种不适。孕育新生命本来就是一项复杂的工程！