妊高征严重并发症对围产儿结局的影响

目的探讨妊高征严重并发症对围产儿结局的影响。方法回顾性研究分析广东省四所医院4107例妊高征大样本的临床资料。结果①妊高征发病率为5.78%,其中重度妊高征占27.78%(1141/4107),中度妊高征占27.71%(1138/4107),轻度妊高征占44.51%(1828/4107)。围产儿死亡率为4.86%(210/4319)。②妊高征严重并发症:胎盘早剥1.68%,DIC1.36%,妊高征性心脏病1.05%,肾功能衰竭0.97%,脑血管意外0.58%、HELLP综合征0.51%。③妊高征严重并发症对围产儿危害依次为:胎盘早剥、DIC、急性肾功能衰竭、HELLP综合征、妊高征性心脏病和脑血管意外。④妊高征严重并发症组早产发生率为83.8%,FGR发生率为76.2%,低体重儿为88.0%,新生儿窒息63.3%,胎儿窘迫59.5%,围产儿死亡31.0%。明显高于无严重并发症组,差异有统计学意义(p<0.05)。⑤妊高征严重并发症组新生儿平均孕龄为(34.57±5.15)周,出生体重(1828±765)g。无严重并发症组中新生儿平均孕龄为(36.97±3.86)周,出生体重(3046±680)g,两组间新生儿孕龄和出生体重均有显著性差异(p<0.05)。结论妊高征严重并发症是围产儿死亡的重要原因。及时正确处理妊高征,减少严重并发症的发生,是改善围产儿结局的关键所在。

AFFECT OF THE SEVERE COMPLICATIONS OF PREGNANCY-INDUCED HYPERTENSION SYNDROME ON THE OUTCOME OF PERINATAL NEWBORN

Objective To analyze the affect of severe complications of pregnancy-induced hypertension syndrome on the outcome of perinatal newborn. Methods Retrospective study of 4 107 PIH among 71 020 cases who delivered in hospital from 1995 to 2004 in Guangzhou. Results ①The morbidity of PIH is 5.78% in which the morbidity of severe PIH is 27.78%(1 141/4 107), the morbidity of midrange PIH is 27.71%(1 138/4 107), the morbidity of mites PIH is 44.51%(1 828/4 107). Maternal mortality rate is 4.86%(210/4 319). ②Each proportion of severe complications in PIH from large to small are as follow: placental abruption is 1.68%, DIC is 1.36%, PIH induced cardiopathy is 1.05%, renal failure is 0.97%, cerebrovascular accident is 0.51%, HELLP syndrome is 0.51%. ③The complications do harm to perinatal newborn seriously range from heaviest to heavier in order are: placental abruption, DIC, HELLP syndrome, PIH induced cardiopathy and cerebrovascular accident. ④Each proportion of perinatal newborn in severe complications are as follow: premature infant is 83.8%(176/210), FGR is 76.2%(160/210), perinatal newborn death is 31.0%(65/210), fetal distress 59.5%(125/210), asphyxia neonatorum is 63.3%(133/210), all of these proportions are larger than the proportions of non-complications group. ⑤In the PIH severe complications group, the gestational age of newborn is (34.57±5.15) weeks, birth weight is (1 828±765) gram; in the non-severe complications group, the gestational age of newborn is(36.97±3.86) weeks, birth weight is (3 046±680) gram. Both gestational age and birth weight have differences with statistically significance between the 2 groups. Conclusion The complications of PIH are the main causes of perinatal newborn death,The high risk of severe complications of PIH can be cut down by detecting and treating PIH as early as possible; It is important to improve pregnancy outcome.