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目的探讨早发型重度子痫前期患者围产儿预后及影响因素。方法选取2005年4月至2008年4月盐城市妇幼保健院收治的妊娠28~33周分娩的早发型重度子痫前期患者90例,分析其围产儿预后及影响因素。结果 90例患者围产儿胎死宫内16例(17.8%),引产中出现死产6例(6.7%),新生儿出现重度窒息死亡10例(11.1%),出生后因急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)死亡2例(2.2%),总死亡率为37.8%(34/90)。随访6年,13例失访,41例存活的新生儿发育过程中无明显异常,2例出现脑瘫。Logistic多元回归显示规律产检(OR=0.192)、分娩孕周(OR=2.217)、新生儿出生体质量(OR=1.003)、胎盘早剥(OR=6.512)、期待治疗天数(OR=6.512),均是影响围产儿死亡的因素(P<0.05)。结论早发型重度子痫前期对产妇和围产儿均有较大的伤害,应根据产妇及胎儿的具体情况选择适时终止妊娠,改善母儿预后。
Objective To investigate the prognosis and the influencing factors of perinatal children with early-onset severe preeclampsia. Methods From April 2005 to April 2008, Yancheng MCH hospital delivered 90 cases of early-onset severe preeclampsia who delivered at 28-33 weeks of gestation. The prognosis and influential factors of perinatal infants were analyzed. Results Totally 16 (17.8%) fetuses died in the uterus in 90 patients, 6 (6.7%) stillbirths in induced labor and 10 (11.1%) newborns died of severe asphyxia. After birth, the patients died of acute respiratory distress syndrome Two patients died of acute respiratory distress syndrome (ARDS), with a total mortality of 37.8% (34/90). After 6 years of follow-up, 13 cases were lost to follow-up, and 41 surviving newborns showed no obvious abnormalities during development. Cerebral palsy occurred in 2 cases. Logistic multivariate regression analysis showed that the regular pregnancy test (OR = 0.192), birth gestational age (OR = 2.217), newborn birth weight (OR = 1.003), placental abruption (OR = 6.512) All the factors affecting perinatal death (P <0.05). Conclusion Early onset severe preeclampsia have a greater harm to both maternal and perinatal children. Pregnancy should be terminated according to the specific conditions of maternal and fetus, and the prognosis should be improved.