Clinical Analysis Of 252 Patients With Severe Preeclampsia

Objective:By comparing the general clinical data,clinical symptoms and signs,auxiliary examination data,adverse pregnancy outcome and prognosis of pregnant women with early-onset severe preeclampsia and late-onset severe preeclampsia,this paper aims to understand the clinical characteristics of early-onset severe preeclampsia and late-onset severe preeclampsia,hoping to explore the influencing factors of early-onset severe preeclampsia and provide references for early prediction and early prevention.Improve maternal and neonatal adverse pregnancy outcomes.Method:A total of 252 pregnant women who delivered in Su Bei Hospital from September 1,2017 to September 1,2022 and met the diagnostic criteria for severe preeclampsia were collected.Patients with severe preeclampsia were divided into two groups:Group A,early-onset severe preeclampsia group（105 cases）:The results of illness during gestational weeks:<34 weeks;Group B,late-onset severe preeclampsia group（147 cases）:The results of illness during gestational weeks≥34 weeks.General clinical data,clinical symptoms and signs,auxiliary examination data,adverse maternal and infant outcomes and prognosis of pregnant women were collected.SPSS statistical software was used to conduct statistical analysis of the collected data,and the influencing factors of early-onset severe preeclampsia were discussed.The independent risk factors were screened by logistics regression analysis,and the predictive value was evaluated by creating a joint prediction model and using the subject operating characteristic curve.Results:1.Comparison of general clinical data:There were statistically significant differences in the number of cesarean section and method of conception between the two groups（P<0.05）.Age,pre-pregnancy BMI,admission BMI,gestational weight gain rate,gestational number,number of births,number of abortions,birth interval,gestational number of births,family history of hypertension,previous history of gestational hypertension,previous history of kidney disease,pregnancy with systemic lupus erythematosus,pregnancy with antiphospholipid antibody syndrome,pregnancy with hyperthyroidism,pregnancy with pregnancy There were no statistically significant differences in pregnancy with hypothyroidism,pregnancy with diabetes,whether insulin was used during pregnancy,blood glucose control,or regular birth test（P>0.05）.2.Comparison of clinical symptoms and signs:The overall difference in blood pressure MAP between the two groups was statistically significant（P<0.05）,while the overall difference in clinical manifestations and signs of the two groups of pregnant women,such as dizziness,headache,blurred vision,chest tightness,shortness of breath,nausea and vomiting,upper abdominal pain or abdominal distension,convulsions,edema,and decreased fetal movement,was not statistically significant（P>0.05）.3.Comparison of auxiliary inspection results:There were statistically significant differences in WBC,ALT,AST,ALP,ADA,LDLC,Apo B,LP（a）,SGr,BUN,UA,Ca,UTP,TT and D-D between the two groups（P<0.05）.There was no significant difference in HB,HCT,NE,LY,MON,NLR,PLR,PLT,PDW,MPV,TG,LDH,TC,HDLC,Apo A,TBA,Cys C,PT,APTT,FIB,heart color ultrasound,abdominal color ultrasound,chest color ultrasound,S/D,amniotic fluid volume and fetal growth ultrasound indexes（P>0.05）.4.Comparison of adverse outcome results:There were statistically significant differences in postpartum hemorrhage,renal function injury,neonatal asphyxia（1minute）and neonatal preterm infants between the two groups（P<0.05）.There were no statistically significant differences in eclampsia,placental abruption,HLLP syndrome,liver function injury,cardiac dysfunction,termination of pregnancy by cesarean section,fundus injury,ICU transfer,neonatal asphyxia（immediate）,neonatal asphyxia（5minutes）,neonatal birth weight and neonatal transfer to neonatal department between the two groups（P>0.05）.5.Comparison of prognosis:the difference of blood pressure control between the two groups was statistically significant（P<0.05）,while the overall difference of postpartum discharge time between the two groups was not statistically significant（P>0.05）.6.Univariate Logistic regression analysis showed that the mode of conception,the pathogenesis MAP,ALP,ADA,LDLC,Apo B,LP（a）,SGr,UA,BUN,UTP and TT were risk factors for early-onset severe preeclampsia.Multivariate Logistic regression analysis was performed to determine that BUN,ALP and UTP were independent risk factors for early-onset severe preeclampsia.The regression equation was P=1/1+e^-y,Y=-0.877+0.309×Bun-0.007×ALP+0.108×UTP.7.ROC curve results showed that pregnancy mode,ADA,LDLC,SGr,Apo B and TT had no significance in predicting the onset of early-onset severe preeclampsia（AUC<0.5）,while MAP,LP（a）,UA,BUN,ALP and UTP alone had low value in predicting the onset of early-onset severe preeclampsia（0.5<AUC<0.7）,the combined prediction model constructed by BUN,ALP and UTP improved the prediction value of early-onset severe preeclampsia（AUC=0.721,95%CI:0.677-0.795）,and the predicted accuracy rate after verification was 76.66%.Conclusion:1.Compared with late-onset severe preeclampsia,the damage degree of liver and kidney function,coagulation function and vascular lesions is more serious,and relevant indicators can predict the occurrence of early-onset severe preeclampsia.2.Method of conception,MAP,ALP,ADA,LDLC,Apo B,LP（a）,SGr,UA,BUN,UTP and TT are risk factors for early-onset severe preeclampsia.3.MAP,LP（a）,UA,BUN,ALP and UTP alone have little value in predicting early-onset severe preeclampsia,but the combined prediction of BUN,ALP and UTP can improve its value.4.Early-onset severe preeclampsia has a higher incidence of adverse pregnancy outcomes and a worse prognosis than late-onset severe preeclampsia...