不同产前检查情况与重度子痫前期及子痫的临床分析

目的分析不同产前检查情况与重度子痫前期及子痫患者的临床特点。 方法回顾性分析在2012年10月至2015年4月清远市人民医院住院分娩的307例单胎妊娠重度子痫前期及子痫患者的临床资料，按照产前检查情况分为：从未检查组(36例)、不规则检查组(146例)、规律检查组(125例)；其中规律产前检查组按检查医院级别分为：一甲医院检查组(17例)、二甲医院检查组(37例)、三甲医院检查组(71例)。比较各组患者的临床基本情况及妊娠结局。 结果(1)母体严重并发症：从未检查组、不规律检查组和规律检查组严重并发症的发生率分别为33.3%、17.1%和8.8%，从未检查组与规律检查组比较，χ²＝－0.292，P<0.017；入住ICU率依次为16.7%，4.6%和1.6%，从未检查组与不规律检查组比较，χ²＝－0.202，从未检查组与规律检查组比较，χ²＝－0.289，P均<0.017。(2)围产儿结局：围产儿不良结局包括胎儿窘迫、轻度窒息、胎儿生长受限、入住ICU、低血糖和死亡；规律检查组与从未检查组的比较，差异有统计学意义。(3)二甲医院检查组和三甲医院检查组极低出生体重儿发生率为16.2%和1.4%, χ²＝－0.285，P<0.017；入住NICU率为40.5%和15.5%, χ²＝－0.278，P<0.017。 结论重度子痫前期及子痫患者接受规律的产前检查，即使在不同级别的医院产检，也可及早发现异常临床表现，并及时处理，改善妊娠结局。

Clinical analysis of relationship between different antenatal examination situations with severe preeclampsia and eclampsia

ObjectiveTo analyze clinical characteristics of the patients with severe preeclampsia and eclampsia under different antenatal examination situations. MethodsFrom October 2012 to April 2015, 307 singleton pregnant patients with severe preeclampsia and eclampsia admitted to Qingyuan City People′s Hospitalwere were enrolled in this retrospective study. According to antenatal examination, patients were divided into 3 groups. Thirty-six cases were in never examination group, 146 cases were in irregular examination group, 125 cases were in regular examination group. According to examination hospital, regular antenatal examination patients were divided into 3 groups. Seventeen cases were in grape-one hospitals examination group, 37 cases were in grape-two hospitals examination group, 71 cases were in grape-three hospitals examination group. Clinical general information and pregnancy outcomes of different groups were compared. Results(1)Maternal complications: The incidences of maternal complications in never examination group, irregular examination group and regular examination group were 33.3%, 17.1% and 8.8%, respectively. There was significant difference between never examination group and regular examination group (χ²=-0.292, P<0.017). The incidences of ICU admission in the 3 groups were 16.7%, 4.6% and 1.6%, respectively. Compare with never examination, irregular examination group and regular examination group were significant difference (χ²=-0.202 and χ²=-0.289, P<0.017)(2)Perinatal fetus outcomes: The adverse outcomes of perinatal fetuses were fetal distress, mild asphexia, fetal growth restriction, NICU admission, hypoglycemia and neonatal death. There were significant differences between never examination group and regular examination group. (3) The incidences of very low birth weight infant in grape-two and grape-three hospitals were 16.2% and 1.4%, and there was significant difference (χ²=-0.285, P<0.017). The incidence of NICU admission in grape-two and grape-three hospitals were 40.5% and 15.5%, and there was also significant difference (χ²=-0.278, P<0.017). ConclusionUnder regular antenatal examination, even severe preeclampsia and eclampsia patients in the different grapes hospitals can detect early clinical abnormalities and have timely treatment to improve the pregnancy outcomes.