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目的探讨重度子痫前期合并胎儿生长受限患者的分娩时机及分娩方式。方法对98例重度子痫前期合并胎儿生长受限病例进行回顾性分析。结果 98例患者中利凡诺引产18例,阴道自然分娩10例,剖宫产70例,剖宫产率71.4%,无孕产妇死亡,所有孕产妇均痊愈出院。孕34周后终止妊娠的新生儿窒息率和围产儿死亡率明显低于孕34周前终止妊娠者。重度子痫前期合并胎儿生长受限经促胎肺成熟等治疗后病情稳定,孕周≥34周估计胎儿成活即可终止妊娠。结论对于孕周已达34周以上的重度子痫前期合并胎儿生长受限患者,经促胎肺成熟治疗后选择适当的分娩方式,尽快结束分娩,是抢救母婴的重要措施。剖宫产是重度子痫前期合并胎儿生长受限终止妊娠的有效措施,但并非唯一措施。
Objective To explore the timing of childbirth and delivery methods in patients with severe preeclampsia and fetal growth restriction. Methods A retrospective analysis of 98 cases of severe preeclampsia with fetal growth restriction was performed. Results Among 98 patients, 18 cases were induced by rivanol, 10 cases were vaginal natural delivery, 70 cases were cesarean and the rate of cesarean section was 71.4%. No maternal death occurred. All pregnant women were discharged. Neonatal asphyxia and perinatal mortality after termination of pregnancy after 34 weeks of gestation were significantly lower than those who discontinued gestation by 34 weeks of gestation. Severe preeclampsia combined with fetal growth restriction by the promotion of fetal lung maturity and other treatment after a stable condition, gestational age ≥ 34 weeks estimated fetal survival can terminate the pregnancy. Conclusions For patients with severe preeclampsia who have gestational age of more than 34 weeks and who have limited fetal growth, it is an important measure to rescue mothers and infants by choosing the mode of delivery after mature fetal lung maturation and ending delivery as soon as possible. Cesarean section is an effective measure for severe preeclampsia with fetal growth restriction termination of pregnancy, but not the only measure.