重度子(癎)前期合并低蛋白血症对围产结局的影响

目的 探讨重度子癎前期合并低蛋白血症对围产结局的影响及其相关性.方法 回顾性分析我院2000年1月至2006年3月收治的233例重度子痢前期患者的临床资料,按血清白蛋白检测结果将其分成低蛋白血症组(A组,133例)和非低蛋白血症组(B组,90例),比较两组孕产妇及围产儿结局.结果 A组孕妇浆膜腔积液(6.8%和0)、肝酶异常(60.9 %和38.9%)、肾功损害(30.1%和11.1%)及并发症(胎盘早剥、产后出血)的发生率(23.3%和11.1%)均高于B组(P<0.05),新生儿出生体重低于B组[(2192.78±795.31)g和(2454.92±776.24)g,P<0.05],围产儿死亡率A组高于B组(26.0%和13.5%)(P<0.05).结论 重度子痢前期合并低蛋白血症可造成母儿的不良结局,应积极防治.充分细致评估母胎状况,尽可能延长孕周改善新生儿结局,若孕妇重要器官受损或并发难治性浆膜腔积液应适时终止妊娠,以改善孕母结局.

Influence of low serum-albumin on maternal and neonatal outcomes in severe pre-eclampsia

Objective To explore the effects of low serum-albumin on maternal and neonatal outcomes in severe pre-eclampsia. Methods Two hundred and thirty-three women with severe preeclampsia admitted to our hospital from Jan. 2000 to Mar. 2006 were retrospectively investigated and were divided into two groups according to the serum-albumin level: low serum-albumin group (Group A, n= 133) and normal serum-albumin group (Group B, n=90). Maternal and fetal outcomes were compared between the two groups. Results The proportion of women with abnormal retention of fluid (6.8%, vs 0), elevated liver enzymes (60.9% vs 38.9%) renal involvement (30.1% vs 11.1%) and complications (23.3% vs 11.1%) (placental abruption and postpartum hemorrhage) in group A were significantly higher than those in group B (all P<0. 05). Birth weight in group A was lower than that in group B[(2192. 78±795. 31) g vs (2454. 92±776. 24) g, P<0. 05] and neonatal mortality in group A was higher (26.0%vs 13. 6%, P<0. 05). Conclusions Severe pre-eclampsia with low serum-albumin is associated with severe maternal and neonatal outcomes. Appropriate termination of pregnancy should be considered following adequate and careful assessment of maternal and fetal well-being in order to improve perinatal outcomes.