早发型重度子痫前期79例妊娠结局分析

目的:探讨早发型重度子痫前期分娩方式与母儿结局的关系。方法:回顾分析79例早发型重度子痫前期妊娠结局,其中47例行剖宫产,32例阴道分娩,比较剖宫产组和阴道分娩组母亲并发症及围产儿结局的差异。结果:①两组孕妇年龄、体重、孕次、分娩孕周、血压、血清生化指标、尿蛋白等比较差异无统计学意义(P0.05)。②阴道分娩组产次、引产前宫颈Bishop评分显著高于剖宫产组,差异有统计学意义(P0.05);而产后出血的发生率显著低于剖宫产组,差异有统计学意义(P0.05);③两组新生儿出生胎龄、出生体重、新生儿窒息发生率、围生儿死亡率差异无统计学意义(P0.05)。结论:早发型重度子痫前期分娩方式应依据病情个体化制定,剖宫产并不能明显改善早发型重度子痫前期围产儿结局,且产后出血风险增加,需严格掌握手术指征;严格选择病例可以考虑引产和阴道分娩。

Analysis on pregnancy outcomes of 79 cases with early onset severe preeclampsia

Objective:To explore the relationship between delivery modes and outcomes of mothers and infants in pregnant women with early onset severe preeclampsia.Methods:The pregnancy outcomes of 79 cases with early onset severe preeclampsia were analyzed retrospectively,47 cases adopted cesarean section and 32 cases adopted vaginal delivery,the incidences of complications of mothers and perinatal outcomes in cesarean section group and vaginal delivery group were compared.Results:There was no significant difference in maternal age,body weight,gravidity,gestational weeks,blood pressure,serum biochemical indicators and urinary protein level between the two groups(P>0.05).The parity,cervical Bishop score before induced labor in vaginal delivery group were significantly higher than those in cesarean section group(P<0.05);while the incidence of postpartum hemorrhage in vaginal delivery group was significantly lower than that in cesarean section group(P<0.05).There was no significant difference in neonatal gestational age,birth weight,incidence of neonatal asphyxia and perinatal mortality between the two groups(P>0.05).Conclusion:The delivery modes of pregnant women with early onset severe preeclampsia should be adopted individually,cesarean section doesn't improve the perinatal outcomes significantly,while the risk of postpartum hemorrhage increases,the surgical indications should be controlled strictly;cases selected strictly may adopt induction of labor and vaginal delivery.