足月子痫前期产妇分娩方式对分娩结局的影响

目的比较足月子痫前期产妇引产和择期剖宫产对分娩结局的影响。方法回顾研究2009年2月1日～2011年3月31日,在杭州市第一人民医院住院分娩的171例足月子痫前期产妇的病例资料。引产组52例,阴道内放置普贝生(地诺前列酮栓)促宫颈成熟或静脉滴注催产素引产;择期剖宫产组119例,根据病情和产妇意愿,由医疗组选择择期剖宫产。比较两组分娩结局及影响产妇分娩方式的因素。结果轻度和重度子痫前期产妇,择期剖宫产率分别为57.3%和85.3%,差异有统计学意义(P<0.001)。子痫前期程度、产妇血压和既往分娩方式等是决定足月子痫前期产妇分娩方式的影响因素。引产组和择期剖宫产组新生儿Apgar评分,新生儿入住NICU率、羊水Ⅲ°浑浊发生率以及母亲产后出血等指标比较,差异均无统计学意义(P>0.05)。结论足月子痫前期产妇引产不影响分娩结局,对病情平稳且有引产指征的产妇鼓励阴道分娩是可行的。

Effects of Delivery Mode on Delivery Outcome in Full-term Pre-eclampsia

Objective To compare the effects of induction and elective cesarean delivery on delivery outcome in full-term pre-eclampsia puerpera.Methods From Feb.1st 2009 to Mar.31st 2011,171 full-term pre-eclampsia puerpera delivered in Hangzhou First People′s Hospital were reviewed.Fifty-two patients received labor induction using propess(dinoprostone suppositories) or intravenous oxytocin.One hundred and nineteen patients admitted to elective cesarean delivery.Delivery outcome and effects of delivery mode were compared between two groups.Results Elective cesarean delivery rate was 57.3% and 85.3% in mild and severe pre-eclampsia puerpera,respectively(P<0.001).Effects of delivery mode included degree of pre-eclampsia,blood pressure,and history of cesarean delivery,etc.There was no statistical difference in the Apgar score,NICU admission rate,rate of Ⅲ degree amniotic fluid turbidity,and postpartum hemorrhage between the two groups(P>0.05).Conclusion Labor induction is not detrimental to delivery outcome in full-term pre-eclampsia puerpera.It is possible to encourage vaginal delivery in selected pre-eclampsia patients.