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目的:分析早发型重度子痫前期期待治疗对母婴预后的影响。方法:分析早发型重度子痫前期患者260例,并根据入院孕周分为3组,A组为孕周<28周(35例),B组为28周≤孕周<32周(116例),C组为32周≤孕周<34周(109例);根据治疗时间又分为4组,Ⅰ组为治疗时间<48h(77例),Ⅱ组为48h≤治疗时间<7天(71例),Ⅲ组为7天≤治疗时间<14天(89例),Ⅳ组为治疗时间≥14天(23例)。比较不同孕周及不同期待治疗时间与各种母胎并发症及围产儿结局的关系。结果:早发型重度子痫前期孕妇最易发生肝肾功能受损、胎盘早剥等并发症。不同治疗时间各组孕妇并发症的发生情况,Ⅳ组明显高于其余3组,差异有统计学意义(P<0.05),而Ⅰ、Ⅱ、Ⅲ组间差异无统计学意义。A组胎死宫内、新生儿窒息、新生儿死亡率明显高于B、C组(P<0.05),而Ⅰ组发生胎死宫内、新生儿窒息、新生儿死亡的机率明显高于其余3个组(P<0.05)。结论:早发型重度子痫前期发病越早,越容易发生母儿并发症,严重威胁孕产妇和胎儿的安危。在严密监护母胎情况下期待治疗7～14天可明显改善围生儿结局,而孕产妇并发症的发生率无明显增加。
Objective: To analyze the effect of expectant treatment of early onset severe preeclampsia on the prognosis of maternal and infant. Methods: Two hundred and seventy patients with early-onset severe preeclampsia were divided into three groups according to the gestational weeks of admission. Group A was gestational week <28 weeks (35 cases), group B was 28 weeks ≤ gestational weeks <32 weeks (116 cases ), Group C 32 weeks ≤ gestational age <34 weeks (109 cases); according to the treatment time is divided into 4 groups, Ⅰ group for treatment time <48h (77 cases), Ⅱ group 48h ≤ treatment time <7 days 71 cases in group Ⅲ), 7 days in group Ⅲ ≤ 14 days (89 cases), and group Ⅳ (≥14 days) in 23 cases. The relationship between different gestational age and different expectant treatment time and various maternal complications and perinatal outcome was compared. Results: Early onset severe preeclampsia pregnant women most likely to have impaired liver and kidney function, placental abruption and other complications. The incidence of complications of pregnant women in each group at different treatment time was significantly higher in group Ⅳ than in the other three groups (P <0.05), but there was no significant difference between groups Ⅰ, Ⅱ and Ⅲ. In group A, the death rate of neonatal asphyxia and neonatal asphyxia in group A was significantly higher than those in group B and C (P <0.05), while the incidence of neonatal asphyxia and neonatal asphyxia in group I was significantly higher than that in the rest 3 groups (P <0.05). Conclusion: The earlier onset of severe preeclampsia occurs, the more likely it is to have maternal complications, which seriously threatens the safety of pregnant women and fetuses. Under the condition of closely monitoring the mother’s fetus, the expectation of treatment for 7 to 14 days can obviously improve the outcome of perinatal children, while the incidence of maternal complications has not obviously increased.