重度子痫前期患者的分娩时机及方式探讨

目的:探讨重度子痫前期患者终止妊娠的时机与方式。方法:对28~41周的155例重度子痫前期患者临床资料进行回顾性分析,观察不同孕周孕妇以及新生儿的妊娠结局。结果:全部产妇均痊愈出院,101例以剖宫产终止妊娠(占65.16%),足月新生儿无1例死亡,早产儿死亡14例,其中孕龄<34周且新生儿体重<1500 g的早产儿死亡率明显增高。不同孕周的孕妇在年龄、血压、分娩方式等方面比较无显著性差异(P>0.05),在24 h尿蛋白定量方面比较有显著性差异(P<0.05)。不同孕周的新生儿在体重、新生儿窒息、新生儿死亡方面比较有显著性差异(P<0.01)。不同分娩方式的新生儿在新生儿窒息、新生儿死亡方面比较无显著性差异(P>0.05)。结论:对重度子痫前期患者孕龄达34周,估计胎儿体重>1500 g,可积极终止妊娠,分娩方式以剖宫产为主。

Study of the time of termination of pregnancy and delivery type for patients with severe pre - eclampsia.

Objective:To investigate the proper time of termination of pregnancy and the method of delivery for patients with severe pre-eclampsia.Methods:Total 155 patients with severe pre-eclampsia from 28 to 41 weeks' gestation were admitted,maternal and natal pregnancy outcome were analyzed retrospectively.Results:All mothers were cured and were discharged home,101 cases were terminated by caesarean section(65.16%).No neonatal death happened in mature newborns,there were 14 cases neonatal death in preterm infants,the mortality increased significantly in those newborns less than 34 weeks' gestation and weight lower than 1 500 g.Pregnancy women with different weeks' gestation had no significant difference in the age,blood pressure and delivery type(P>0.05),had significant difference in the 24-hour proteinuria(P<0.05).There were very significant difference in newborn weight,neonatal asphyxia and neonatal morbility among newborns with different weeks' gestation(P<0.01).There were no significant difference in asphyxia and morbility for newborns with different delivery type(P>0.05).Conclusion:Pregnancy can be terminated actively in patients with severe pre-eclampsia who has more than 34 weeks' gestation and expected fetus weight more than 1 500 g,caesarean section may be the major method of termination of pregnancy.