双胎妊娠并发子痫前期临床比较分析

摘要

目的：探讨双胎妊娠并发子痫前期的临床特点及围产结局。方法：回顾分析江阴市人民医院妇产科及东南大学附属中大医院妇产科2009年1月至2012年12月收治的双胎妊娠并发子痫前期30例孕妇及同期双胎正常妊娠30例孕妇的临床资料。对所有纳入对象进行临床流行病学调查，分析比较两组临床资料，包括孕妇一般情况、个人史、既往史及家族史、月经及婚育史、孕期情况和分娩结局等。结果：双胎妊娠并发子痫前期组与双胎正常妊娠组孕前及分娩前BMI、孕期体重增长比较，差异有统计学意义（均P＜0．05）；双胎妊娠并发子痫前期组中低蛋白血症、早产、产后出血发生率显著高于双胎正常妊娠组（均P＜0．05）；双胎正常妊娠组胎膜早破发生率高于双胎妊娠并发子痫前期组（P＜0．05）；双胎妊娠并发子痫前期组中血白蛋白、血小板计数显著低于双胎正常妊娠组，而血肌酐显著高于双胎正常妊娠组（均P＜0．05）；双胎妊娠并发子痫前期组剖宫产率高于双胎正常妊娠组（P＜0．05）。结论：临床资料分析显示，孕前BMI过高、孕期体重增长过多为双胎妊娠并发子痫前期的常见表现；早产、低蛋白血症、产后出血为双胎妊娠并发子痫前期较常见的并发症；双胎妊娠并发子痫前期可出现血小板减少、血肌酐升高、白蛋白降低等表现。%Objective: To explore clinical features of maternal and neonatal outcomes of twin preeclampsia pregnancies .Methods:Thirty twin pregnant women with preeclampsia were selected as observation group .Thirty cases of normal twin pregnant women , clinical data over the same period , were selected as a control group .All of them came from Jiangyin People's Hospital and Zhongda Hospital Affiliated to the Southeast University from January 2009 to December 2012.All of them were Chinese Han people and all pregnant women were twin pregnant women . All the objects were included in clinical epidemiology , clinical data analysis , including general , personal history , medical history and family history , menstrual and obstetrical history , pregnancy and childbirth outcomes and other circumstances .Results: Compared with twins normal pregnancy the twins preeclampsia pregnancy had higher childbirth before BMI and weight gain during pregnancy comparison , the difference was statistically significant ( P<0 .05 ); The incidence rate of hypoalbuminemia , premature delivery , postpartum bleeding in twins preeclampsia group was significantly higher than the normal twin pregnancy group ( P<0.05); The incidence rate of premature rupture of membranes in twin normal pregnancy group was higher than twins preeclampsia group ( P<0 .05 );Serum albumin, platelet count of twins preeclampsia group was significantly lower than the normal twin pregnancy group , while serum creatinine was significantly higher than the normal twin pregnancy group ( P<0.05 );Cesarean section rate of twins preeclampsia group was higher than the normal twin pregnancy group ( P <0 .05 ) .Conclusion:Clinical data analysis showed that high BMI of pre-pregnancy and excessive weight gain during pregnancy is a common manifestation of preeclampsia twins .Preterm labor , premature rupture of membranes , hypoproteinemia , and postpartum hemorrhage are the common complications of twin pregnancies complicated by preeclampsia .Twin pregnancy complicated by preeclampsia can lead to thrombocytopenia , serum creatinine elevated , albumin decreased ,and so on .