子痫前期保守治疗及终止妊娠时间的探讨
子痫前期,,子痫前期；治疗；妊娠结局,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨子痫前期保守治疗的临床意义及适时终止妊娠的时间。方法 回顾分析2002年1月～2004年8月我院收治的67例子痫前期的临床资料。按其发病孕周分为：A组(<32周)6例，B组(32～33周)2例，C组(34～37周)16例，D组(≥37周)43例。主要分析指标包括：发病孕周、终止妊娠孕周、孕周延长时间、严重并发症发生情况、胎儿及新生儿死亡率。结果 (1)A组保守治疗时间平均为(46.2±18.2)天，B组为(19.0±7.1)天，C组为(12.2±9.0)天，D组为(5.2±7.8)天，差异有非常显著性(P<0.01)。C、D组并发症发生率的比较，差异无显著性(P>0.05)，但与A、B组比较，差异有非常显著性(P<0.01)。A组与B、C、D组胎儿及新生儿死亡率的比较，差异有显著性(P<0.05)。孕32周前终止妊娠的子痫前期患者胎儿及新生儿死亡率与孕32周后终止妊娠患者比较差异有显著性(P<0.05)。结论 子痫前期发病于32周前，孕妇并发症发生率、胎儿及新生儿死亡率高，采取保守治疗至32或34周后，胎儿及新生儿死亡率降低，而孕妇并发症有所上升。故应严格选择病例，并严密监护，适时终止妊娠。【关键词】 子痫前期；治疗；妊娠结局
Expectant management and gestational age of delivery in preeclampsia
SHI Hui-min.
Department of Obstetrics and Gynecology,Jiangyin Peoples Hospital,Jiangyin 214400,China
【Abstract】 Objective To investigate the difference of maternal and perinatal outcome with expectant management and gestational age at delivery of preeclampsia.Methods 67 cases meeting preeclampsia who underwent expectant management were enrolled in this study.Patients were divided into 4 groups according to gestational age of onset:group A(n=6)with onset before 32 weeks gestation,group B(n=2)with onset during 32～33 weeks gestation,group C(n=16) with onset during 34～37 weeks gestation,group D(n=43) with onset≥37 weeks gestation.Main parameters measured included prolongation of gestigation,perinatal mortality rate and severe complication.Results The average pregnancy prolongation was (46.2±18.2)days,(19.0±7.1)days,(12.2±9.0)days,(5.2±7.8)days respectively in groups A,B,C,D.The onset gestational age and the gestational age at delivery was closely associated with the perinatal outcome(P<0.01).Perinatal mortality of who onset before 32 weeks gestation was significantly higher than those onsetting after 32 weeks gestation.Severe complication morbidity onsetting before 34 weeks gestation was significantly higher than that onsetting before 34 weeks gestation.Perinatal mortality before 32 weeks gestational age of delivery was significantly higher than that after 32 weeks gestational age of delivery.Conclusion Perinatal mortality and severe complication morbidity was significantly higher than that onsetting after 32 weeks gestation.Expectant management should be carried out until ≥32 weeks gestation even ≥34 weeks when perinatal mortality decreases and complication occurency increases.Patients with preeclampsia shoud be cared intensively and termed gestation at right time. ......
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