137例重度子痫前期母婴结局临床分析

目的:分析不同孕周重度子痫前期发病与母婴结局的关系,为临床工作提供指导.方法:137例重度子痫前期患者,根据其孕周不同分为A(孕周＜32周)、B(32周≥孕周＜37周)、C(≥37周)三组,比较三组间孕产妇并发症发生情况和围生儿预后情况及分娩方式.结果:A、B、C三组孕产妇并发症发生率分别为59.3%、32.5%和20.3%,A组与B、C两组比较有统计学意义(P＜0.05).三组间孕产妇死亡率比较差异无统计学意义(P＞0.05).A、B、C三组围生儿死亡率分别为48.1%、17.3%和3.2%,三组间比较差异有统计学意义(P＜0.05);三组间胎儿生长受限、胎儿窘迫及新生儿窒息发生率比较,差异均有统计学意义(P＜0.05).三组总剖宫产率92.0%,阴道分娩率8.0%(P＜0.05);产时子痫发生率剖宫产组为0、阴道分娩组为27.3%,两者比较差异有统计学意义(P＜0.05 );两种分娩方式死产发生率比较,差异无统计学意义(P＞0.05).结论:重度子痫前期孕妇严重并发症发生率高和围生儿死亡率高,且发病孕周越小发生率越高.在保证孕妇安全情况下采取保守治疗,适当延长胎龄,促进胎儿成熟,可提高新生儿存活率.分娩方式以剖宫产为最佳选择.

Severe Preeclampsia and Maternity-Perinatal Outcomes: Clinical Analysis of 137 Cases

Objective：To analyze different gestational weeks about severe preeclampsia onset and maternity - perinatal outcomes. Methods ：137 cases with severe preeclampsia were retrospectively analyzed from Jan. 2007 to Jan. 2010, they were divided into 3 groups according to different gestational weeks： group A （gestational weeks before 32weeks） , group B （gestational weeks after 32weeks and before 37weeks） , group C （gestational weeks after 37 weeks）. The time of termination, expectant treatments about pregnant and parturient women, perinatal mortality, maternal mortality and delivery mode selection in 3 groups were compared. Resuits：The difference of complication rate between group A （59.3%）, group B （32.5%） and C （20.3 % ） was statistically significant （P 〈 0.05）. There was no significance in maternal mortality among the three groups （P 〉0.05）. Three groups around the perinatal mortality： group A 48.1% ,group B 17.3% ,group C 3.2%. The difference of perinatal mortality among 3 group was significant （ P 〈 0.05 ）. The FGR incidence rate and fetal distress and asphyxia neonatorum were significant among three groups （ P 〈 0.05 ）. The abdominal delivery rate of three groups ： 92% , vaginal delivery rate：8 %. There was no significant among three groups （P 〈 0.05 ）, The rate about eelampsia by abdominal delivery was 0% , by vaginal delivery 27.3%. There was significance between them. There was no significance about the two delivery methods. Conclusions：Severe preeclampsia maternity often accompanied high complication rate and perinatal mortality rate. There are higher rate when the oneset gestation ages are low. Conservative treatment should be adopted to ensure maternity safe, to adequately extend the gestational age, to promote the maturity of fetus and to improve the fraction survival rate of new birth baby.