摘要
目的对足月不同孕周的妊娠期高血压及子痫前期孕妇阴道分娩结局进行研究。方法回顾性分析2021年5月至2023年5月成都市龙泉驿区第一人民医院收治的264例选择经阴道试产分娩的妊娠期高血压及子痫前期孕妇的临床资料,以分娩时孕周分为4组:A组37~37+6周(96例),B组38~38+6周(56例),C组39~39+6周(64例),D组40周以上(48例)。分析4组孕妇产前血清白蛋白含量、尿酸值、24 h尿蛋白含量及阴道试产成功率与阴道分娩的母儿结局。结果4组孕妇血清白蛋白含量、尿酸值、24 h尿蛋白含量比较差异无统计学意义(P>0.05),4组降压药使用比例、助产率、新生儿转科率比较,差异有统计学意义(P<0.05);分娩过程中,A、B组需引产比例最高,D组产程最长(P<0.05);4组产后出血、阴道分娩成功率及病情加重比例比较,差异无统计学意义(P>0.05);新生儿方面,A组新生儿体重低于其他三组(P<0.05),4组新生儿1 min Apgar评分比较,差异无统计学意义(P>0.05),D组新生儿脐动脉血气pH值明显低于A组及B组(P<0.05)。结论孕38~39^(+6)周妊娠期高血压及子痫前期孕妇经阴道分娩终止妊娠,母儿结局均良好,大于40周后经阴道分娩的母儿风险明显增加。
Objective To study the outcomes of vaginal delivery in full-term women with gestational hypertension and preeclampsia at different gestational weeks.Methods The clinical data of 264 pregnant women with gestational hypertension and preeclampsia who selected vaginal trial labor in the First People's Hospital of Longquanyi District of Chengdu from May 2021 to May 2023 were retrospectively analyzed.According to the gestational age at delivery,they were divided into four groups:group A(37~37~(+6)weeks,n=96),group B(38~38~(+6)weeks,n=56),group C(39~39~(+6)weeks,n=64)and group D(40 weeks,n=48).The levels of serum albumin,uric acid,24 h urine protein and the success rate of vaginal delivery,the maternal and fetal outcomes of vaginal delivery were analyzed.Results There was no significant difference in serum albumin content,uric acid value and 24 h urinary protein content among the four groups(P<0.05).There were significant differences in the proportion of antihypertensive drugs,midwifery rate and neonates transfer rate among the four groups(P<0.05).During labor,groups A and B had the highest proportion of labor induction,group D had the longest labor(P<0.05).There were no significant differences in the postpartum hemorrhage,success rate of vaginal delivery and the proportion of disease aggravation among the four groups(P<0.05).In terms of neonates,the weight of neonates in group A was significantly lower than group A and group B(P<0.05).There was no significant difference in 1-minute Apgar score among the four groups(P>0.05).The pH value of umbilical avtery blood gas in group D was significantly lower than that in the other three groups(P<0.05).Conclusion Vaginal delivery in women with gestational hypertension and preeclampsia at 38~39^(+6)weeks of gestation has good maternal and fetal outcomes.The risk of vaginal delivery is significantly increased after 40 weeks of gestation.
作者
毛胜艳
林春霞
周隽
郑钊平
代庆凯
Mao Shengyan;Lin Chunxia;Zhou Jun;Zheng Zhaoping;Dai Qingkai(Department of Obstetrics,the First People's Hospital of Longquanyi District(West China Longquan Hospital Sichuan University),Chengdu Sichuan 610100;Key Laboratory of Birth Defects and Related Maternal and Child Diseases of the Ministry of Education,Laboratory,West China Second Hospital,Sichuan University,Chengdu Sichuan 610041,P.R.China)
出处
《中国计划生育和妇产科》
2023年第10期82-85,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
成都市龙泉驿区卫健系统科研课题(项目编号:WJKY019)。
关键词
妊娠期高血压
子痫前期
孕周
阴道分娩
分娩结局
gestational hypertension
preeclampsia
gestational weeks
vaginal delivery
delivery outcome
作者简介
毛胜艳,毕业于重庆医科大学,硕士研究生,主治医师,主要研究方向为产科学;通信作者:林春霞,E-mail:986138020@qq.com。
