子痫前期病史孕妇再次妊娠临床特点及母婴结局分析

摘要

目的 探讨早发型及晚发型子痫前期病史孕妇再次妊娠临床特点及母婴结局.方法 选取余姚市人民医院妇产科2011年1月至2016年12月收治的98例子痫前期病史孕妇作为研究对象,分析子痫前期病史孕妇再次妊娠临床特点并分析其母婴结局.结果 前次妊娠为早发型子痫前期的患者本次妊娠临床表现中头痛、眼花、头晕发生率均显著高于晚发型子痫前期患者(x2值分别为10.309、13.608、17.610,均P＜0.05),且24h尿蛋白定量值显著高于晚发型子痫前期患者(x2=5.232,P＜0.05).前次妊娠为早发型子痫前期患者本次妊娠妊娠期高血压疾病发病率高于晚发型子痫前期患者,但差异无统计学意义(2=1.768,P＞0.05)而本次妊娠并发症显著高于晚发型子痫前期患者(x2=25.247,P＜0.0l),主要为肝功能损害(27.50％)、肾功能损害(20.00％),两组患者胎盘早剥、产后出血发生率无显著性差异(x2值分别为0.071、0.803,均P＞0.05).前次妊娠为早发型子痫前期患者新生儿窒息、低体重儿、新生儿低血糖、新生儿死亡发生率均显著高于晚发型子痫前期患者(x2值分别为5.009、10.648、7.701、4.487,均P＜0.05),两组胎儿生长受限、新生儿湿肺、新生儿呼吸窘迫综合征发生率均无显著性差异(x2值分别为0.803、0.001、1.465,均P＞0.05).结论 血压增高、蛋白尿是子痫前期孕妇再次妊娠的主要临床特点,子痫前期孕妇孕周越短,出现并发症越高,且围产儿结局相对越差.%Objective To explore the clinical characteristics and maternal and neonatal outcomes of subsequent pregnancy with early-onset or late-onset preeclampsia history.Methods Totally 98 pregnant women with preeclampsia history were selected during January 2011 to December 2016 in People's Hospital of Yuyao City.The clinical characteristics and maternal and neonatal outcomes of subsequent pregnancy with preeclampsia history were analyzed.Results The incidences of headache,vertigo and dizziness in this pregnancy in patients with early-onset preeclampsia in previous pregnancy were significantly higher than those in patients with late-onset preeclampsia in previous pregnancy (x2 value was 10.309,13.608 and 17.610,respectively,all P ＜ 0.05).The quantitative value of 24h urine protein of the patients with early-onset preeclampsia in previous pregnancy was significantly higher than that in patients with late-onset preeclampsia in previous pregnancy (x2 =5.232,P ＜ 0.05).The incidence of gestational hypertension in this pregnancy in patients with early-onset preeclampsia in previous pregnancy was higher than that in patients with late-onset preeclampsia in previous pregnancy,but there was no statistically significant difference (x2 =1.768,P ＞ 0.05).The incidence of pregnancy complications in this pregnancy in patients with early-onset preeclamnpsia in previous pregnancy was significantly higher than that in patients with late-onset preeclampsia in previous pregnancy (x2 =25.247,P ＜ 0.01).The main complications included liver function lesion (27.50％) and renal function impairment (20.00％).There was no significant difference in the incidence of placental abruption and postpartum hemorrhage between two groups (x2 value was 0.071 and 0.803,respectively,both P ＞ 0.05).The incidence of neonatal asphyxia,low birth weight,neonatal hypoglycemia and neonatal death in patients with early-onset preeclampsia in previous pregnancy were significantly higher than that in patients with late-onset preeclampsia in previous pregnancy (x2 value was 5.009,10.648,7.701 and 5.009,respectively,all P ＜ 0.05).But there was no statistically significant difference in the incidence of fetal growth restriction,transient tachypnea of the newborn and neonatal respiratory distress syndrome between two groups (x2 value was 0.803,0.001 and 1.465,respectively,all P ＞ 0.05).Conclusion High blood pressure and proteinuria are the main clinical characteristics of the subsequent pregnancy in pregnant women with preeclampsia history.The shorter the gestational age of subsequent pregnancy in pregnant women with preeclampsia history,the higher the incidence of complications,and the worse the perinatal fetus outcomes.