Clinical Analysis On Expectant Management Of Severe Pre-eclampsia

Objective:To explore the importance and feasibility of Expectant Management of severe pre-eclampsia and the impact on out come of gest-ation.Methods:The study was conducted in 99 pregnant women with S-PE(gestational week between 25+5-35+6w) during the April 2004 to the January 2009 in our hospital.Divided all the cases into Group A with the gestational week between 25+5-31+6w and Group B with the gestational week between 32-33+6w and Group C with the gestational week between 34-35+6w, and then divided the three Groups into Group A1,B1,C1 with the Expectant Management and Group A2,B2,C2 with the Aggressive Management.A retrospective study is to analysis the importance and feasibility of Expectant Management of severe pre-eclampsia and the impact on out come of gest-ation.Results:(1) There was no maternal death,cerebrovascular accident and eclampsia in all the cases.In group 25+5-33+6 week, the rate of the renal,placental function damage,proliferative diabetic retinopathy and thrombocytopenia of the ExpectantManagement was not higher than the Aggressive Manage-ment,there was no significant difference between the two groups(p>0.05);But the rate of the Liver function damage of the Expectant Management was 16.67% which was lower than the Aggressive Management that was 46.67%, there was too significant difference between the two groups(p<0.05).(2)In group 25+5-33+6 week, the rate of the neonatal asphyxia,FGR and neonatal death of the Expectant Management was much lower than the Aggressive Manage-ment,there was significant difference between the two groups(p<0.05).In group 34-35+6 week, the rate of newborn shifting into NICU(neonatal intensive care unit) of the Expectant Management was much lower than the Aggressive Management,there was significant difference between the two groups (p<0.05). (3)The termination of pregnancy about severe pre-eclampsia was almost caesarean section,but there was no significant difference about the mode of delivery between the Expectant Management and the Aggressive Management (p<0.05).(4)The average pregnancy prolongation in three groups about A1,B1,C1 were (6.55±2.93),(9.23±4.48),(6.15±3.35) days,the longest one was B1,which has significant difference with other groups(p<0.05).Conclusion:(1)In group 25+5-33+6 week of severe pre-eclampsia,with the mother and fetus' condition stabilized,to give appropriate expectant manage-ment could not release the rate of the organ damage.(2)In group 25+5-33+6 week of severe pre-eclampsia, with the mother and fetus'condition stabilized, to give appropriate expectant management could perfect the ending of the fetus.(3)In group 34-35+6 week of severe pre-eclampsia,if the mother and fetus' condition stabilized, appropriate expectant management should be given to decrease the rate of newborn shifting into NICU.(4)In group 32-33+6 week of severe pre-eclampsia,the average pregnancy prolongation of the expectant manage-ment could be longer than other gestational week.