重度子痫前期并发腹水46例分析

目的 探讨重度子痫前期并发腹水终止妊娠的时机和方式对母儿的影响。方法 对46例重度子痫前期并发腹水患者进行回顾性分析。结果 46例患者均有低蛋白血症,并发腹水均根据临床检查、B超、剖宫产证实,重度子痫前期并发腹水占重度子痫前期的12.5%,伴胎儿生长受限者占63.0%,围产儿死亡率37.5%,剖宫产率82.6%,并发DIC、肾衰3例,其中1例孕产妇死亡,余全部存活。孕周〈34周者新生儿窒息率,围产儿死亡率均高于孕周〉34周以上者。结论 对重度子痫前期并发腹水经积极期待治疗,适时终止妊娠是唯一有效方法,一旦终止妊娠,病情多迅速好转,得到控制。终止妊娠的方式首选剖宫产。

Analysis of 46 cases of severe pre-eclampsia with ascites

Obsjeclive] To investigate the effects of time and methods of pregnancy termination in severe preeclampsia with ascites on mothers and fetals. Methods] To retrospective analyse 46 patients suffered from severe pre-eclampsia with ascites. Results] All 46 patients had hypoproteinemia and ascites was proved by clinicalexam- ination, B uhrasonography or cesarean section. Severe pre-eclampsia with ascites was 12.5% and with fetal growth restrictionwas 63.0%. The perinatal mortality was 37.5%. The cesarean section rate was 82.6%. 1 pregnant woman of 3 patients who compounded with DIC and kidney failure was dead and other women all survived. Neonatal asaphyxia rate and perinatal mortality of them whose pregnant days less than 34 weeks was higher than those whose pregnant days more than 34 weeks. Conclusions] In severe pre-eclampsia with ascites, terminating pregnancy in time is the only effective method after active waiting treatment. Most patients should get well as soon as terminated pregnancy and cesarean section is the first choice.