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目的:分析重度子痫前期临床特征、妊娠结局及围产儿死亡的预后因素,为提高围产期保健干预提供参考。方法:回顾性分析614例重度子痫前期患者,并根据其发病孕周分为<32周组52例,32～<34周组52例,34～<37周组127例;≥37周组383例。分析患者的一般临床资料、保健情况和妊娠结局,比较产妇并发症及围产儿预后情况。结果:614例重度子痫前期患者中,孕妇死亡2例,子宫切除4例,围产儿总数579例,其中围产儿死亡18例。发病在<32周组和32～<34周组的HELLP综合征、围产儿死亡、出生缺陷、新生儿窒息的比例大于其他两组(P<0.05),而分娩孕周则低于其他两组(P<0.05)。重度子痫前期患者的发病时间与围产儿死亡存在强相关:患者发病孕周<34周的OR值为38.09(1.72～842.86)。结论:34周前发病的重度子痫前期患者容易出现母儿不良预后,且发病越早,母儿预后越差。加强宣教,提高人群的自我保健和及时就诊意识,有利于重度子痫前期早期诊断、早期治疗,减少患者并发症和不良妊娠结局的发生。
Objective: To analyze the clinical characteristics of severe preeclampsia, the outcome of pregnancy and the prognosis of perinatal mortality and provide reference for improving perinatal care intervention. Methods: A total of 614 patients with severe preeclampsia were retrospectively analyzed. According to their gestational age, 52 cases were divided into 32 weeks, 52 cases between 32 and 34 weeks, 127 cases between 34 and 37 weeks, 383 cases. Analysis of the general clinical data of patients, health conditions and pregnancy outcomes, maternal complications and perinatal prognosis. Results: Of 614 patients with severe preeclampsia, 2 were pregnant women, 4 were hysterectomies, 579 were perinatal ones, among which 18 were perinatal deaths. The incidence of perinatal death, birth defects and neonatal asphyxia in HELLP syndrome group <32 weeks and 32- <34 weeks was greater than that in the other two groups (P <0.05), while gestational age was lower than the other two groups (P <0.05). The onset time of patients with severe preeclampsia was strongly correlated with perinatal death. The OR of patients with gestational weeks <34 weeks was 38.09 (1.72 ~ 842.86). Conclusion: Patients with severe preeclampsia who developed disease 34 weeks ago were prone to maternal and child adverse prognosis, and the earlier onset, the poorer the prognosis of maternal and child. Strengthen the mission, improve self-care of the population and timely treatment awareness, is conducive to early diagnosis and treatment of severe preeclampsia, early treatment and reduce the incidence of complications and adverse pregnancy outcomes.