摘要
目的:探讨孕28周前发生的妊娠期高血压疾病的临床特点及预后。方法:28周前发生的妊娠期高血压26例,轻度子痫前期26例,重度子痫前期30例,以28周以后发生的妊娠期高血压疾病作为相应的对照组。结果:妊娠期高血压、轻度子痫前期分别有69.2%、77.7%发展成重度子痫前期,3组严重并发症:子痫、心衰、肾功能衰竭、HELLP综合征、眼底出血。胎盘早剥的总发生率分别是26.9%,42.3%,50%,均比相应的对照组高(P值<0.05);胸腹水、低蛋白血症、24 h尿蛋白定量>5 g、血小板减少、血粘度增高的发生率均比相应的对照组高(P值<0.05)。胎儿生长受限的发生率分别是15.4%,42.3%,53.3%,FGR总发生率为37.8%,与对照组比较,FGR的总发生率明显升高(P值<0.05),围产儿死亡率分别是23%,57.7%,83.3%,均比相应的对照组高(P值<0.01)。结论:发生在28周以前的妊娠期高血压疾病的母儿结局不良,早期诊断和治疗,开展预测和预防是改善母儿预后的关键。
Objective： To speculate the clinical feature and treatment of hypertensive disorder complicating pregnancy diagnosed before 28 gestational weeks. Methods： 26 gestational hypertension, 26 mild preeclampsia and 30 severe preeclampsia diagnosed before 28 gestational weeks were observed, the control group including 90 case for hypertensive disorder complicating pregnancy occurred after 28 gestational weeks. Results： There were 18 cases （69. 2% ） developing into severe preeclampsia in 26 gestational hypertension and 20 eases （77%） developing into severe preeelampsia in 26 mild preeelampsia. The severe complications included HELLP syndrome, eclampsia, heart failure, renal failure and eyeground blooding. The total rate of placental abruption was 26. 9% in gestational hypertension, 42. 3% in mild preeclampsia, 50% in severe preeclampsia and were significantly higher compared with that in corresponding control groups （P 〈 0. 05 ） ; The rates of hydrothorax and ascites hypoalbuminemia, urinary protein 〉 5 g in 24 hours, elevated blood viscosity, thrombocytopenia were higher in each observed group than those in corresponding control group （P 〈 0. 05 ）. The rate of the fetal growth restriction （FGR） in observed group was 15. 4% for gestational hypertension, 42. 3% for mild preeclampsia and 53. 3% for severe preeclampsia and the total rate of FGR were significant higher than that in control group （P 〈 0. 05）. The perinatal mortality in gestational hypertension in mild preeclampsia and severe preeclampsia, perinatal mortality were 23% , 57. 7% and 83. 3% respectively and the rate of perinatal mortality in each observed group was higher than that in corresponding control group （P 〈 0. 01 ） . Conclusion： The perinatal outcome of hypertensive disorder complicating pregnancy diagnosed before 28 gestafional weeks is unfavourable in severe preeclampsia especially, early diagnosis as well as immediate and proper treatment are very important. The prediction and prevention of early onset preeclampsia are the key to improve the perinatal outcome.
出处
《中国妇幼保健》
CAS
北大核心
2007年第21期2906-2909,共4页
Maternal and Child Health Care of China
关键词
早发型子痫前期
晚发型子痫前期
妊娠期高血压疾病
Hypertensive disorder complicating pregnancy
Early onset preeclampsia
Late onset preeclampsia
