子癎发生的临床特点及预防

目的分析子癎发病的高危因素,探讨子癎的预防、终止妊娠的时机和方式及对母婴的影响。方法回顾性分析我院1993年1月至2004年10月收治的35例子癎的临床资料。结果 12年内子癎发生率为0．25％,每4年子癎的发生率逐渐下降,差异有显著性(P<0．01)。子癎的发生与季节及气候有关,发生在 9至2月者28例,占80％。35例子癎中,未行产前检查27例(77．14％),剖宫产29例(82．86％),新生儿窒息 12例(34．29％),早产8例(22．86％)。孕33-<37周与≥37周子癎发生新生儿窒息的差异无显著性。子癎抽搐不同次数与新生儿窒息无明显关系,但与治疗至终止妊娠的时间有关,治疗子癎至终止妊娠时间≤4 h者发生新生儿窒息的比例高于>4 h者。子癎痊愈率为100％。结论积极控制子癎的发作、及时终止妊娠是治疗子癎 的重要措施;加强外来流动孕产妇系统管理及建立三级妇幼保健网,对降低子癎发生率及减少母婴并发症有重要意义。

Clinical characteristics and prevention of eclampsia

Objective To analyze the risk factors of eclampsia and its preventive measure and to appraise the time and means of terminating the pregnancy with effects on mother and fetus. Methods A retrospective analysis was done on the clinical data of 35 in-patient cases of eclampsia in our hospital from Jan. 1993-Oct. 2004. Results The average incidence of eclampsia in 12 years was 0.25% , with a gradual significant decrease tendency every four years onward (X2= 13. 76 , P < 0. 01). 28 cases (80%) eclampsia occurred in Sept. to Feb. showing the close relationship to season and climate. Among 35 cases, 27 (77. 14%) did not attend the clinic before delivery, 29 (82. 86%) undertook cesarean section, 12 (34. 29%) had infantile asphyxia, 8 (22. 86%) experienced premature delivery. There was no significant difference in the incidence of infantile asphyxia between 33-37 and >37 weeks pregnancy in eclampsia cases. The incidence of infantile asphyxia was not related to different occasions of convulsion, but related to the time of therapy and the duration toward terminating pregnancy; i. e. less than 4 hours, the proportion of infantile asphyxia was higher than that in the period more than 4 hours'. The cure rate of eclampsia was 100%. Conclusion Control the eclampsia episode and terminate the pregnancy in due time are the most important measures for treatment of eclampsia. Strengthening the administrating management of the pregnant women coming from outside Shanghai and constructing three-grade health care network for pregnant women and newborn infants are the major importance for reducing the incidence of eclampsia and maternal and fetal complications.