早发型重度子痫前期终止妊娠时机与围生结局分析

目的探讨早发型重度子痫前期终止妊娠时机与围产结局的关系；进一步研究早发型重度子痫前期的期待保守治疗的临床意义。方法回顾分析2001年1月至2007年6月的91例早发型重度子痫前期患者，分为两组A组积极治疗组、B组期待治疗组（入院期待治疗48h后终止妊娠），比较两组围生结局。结果A组41例终止妊娠孕周数31w±6．7d，围生儿病死率68．5％，B组50例终止妊娠孕周数32w±9．2d，围生儿病死率14％，B组的围生儿病死率、新生儿窒息率和NICU住院率均低于A组（P〈0．05），B组的新生儿体质量明显大于积极治疗组（P〈0．01）。结论选择合适的早发型重度子痫前期孕妇进行期待治疗，可以明显改善围生儿结局，对孕产妇也是安全和可行的。

Study of the timing of pregnancy termination on maternal and perinatal outcome in early - onset severe pre-eclampsia

Objective To study the relationship between the timing of pregnancy termination on maternal and perinatal outcome in early-onset severe pre-eclampsia. Methods Ninty-one women with early - onset severe pre - eclampsia admitted to our hospital from Jan. 2001 to July. 2007 were retrospectively investigated. They were divided into two groups :group A with the expectant management and group B with the aggressive managemet(terminate pregnancy after 48hours admitted to hospital), compared their perinatal outcome. Results In group A(n=41) . The average time of pregnancy termination was 31w±6.7d. The perinatal infant mortality rate was 68.5%. In group B (n=50). The average time of pregnancy termination was 32w±9.2d. Expectant treatment time was (9.3±4.5) d. The perinatal infant mortality rate was 14.3%. The rate of neonatal asphyxia and hospitalization in neonatal intensive care unit (NICU) with expectant manage-ment was lower than that with aggressive management (P<0.05). And the birth weight in the expectant management was significantly higher than that in aggressive management (P<0.01). Conclusion The expectant management can be suitable for part of pregnant women who get early-onset severe pre-eclampsia, which can improve the result of perinatal infantand also is safe and feasible for the pregnant women.