A Comparative Study On Early Onset And Late Onset Severe Preeclampsia

Objective To analyze the characteristics of early and late onset severe preeclampsia involving maternal major complications,the method of pregnancy termination and perinatal outcomes;To evaluate perinatal outcomess of expectant management of early onset severe preeclampsia.Methods One hundred and forty-severn cases meeting the criteria of severe preeclampsia were enrolled in this study,By logistic analyse method in zibo maternal and infant health care hospital in April 2007 to March 2008.Patients were divided into two groups:group A(n=51) with those onset≤34 weeks of gestation and group B(n=96) with onset＞34 weeks of gestation.The clinical data,pattern of organ damage,complications,and maternal and perinatal outcomes were compared of the two groups.Early onset group were divided into two groups by accepetting exceptant management or not as group A₁ (n=13) and group A₂(n=38) to compare the maternal major complications and perinatal outcomes.Results There were less gravida in early onset group than in late onset group who had standard antenatal care(P＜0.05);There were significant differences between group A and group B in gestationa weeks of onset,systolic pressure, diastolic pressure,gestationa weeks of termination and the days of management(P＜0.01);The incidence of maternal major complications including hypoproteinemia,hepatic dysfunction,renal dysfunction,placental abruption,HELLP syndrome were different between group A and B;and the incidence of SGA,perinatal mortality and admission to NICU were also different between group A and group B(P＜0.01);There were no significant differences in the incidence of maternal major complications and SGA, neonatal asphyxia and admission to NICU between group A₁ and group A₂ (P＞0.05).But significant differences in favor of expectant management were noted in perinatal mortality and time for NICU(P＜0.05);Cesarean section was a main method of pregnancy termination to chooce for all groups.Conclusion Early onset severe preeclampsia is easy to have many kinds of complications,affect maternity and perinates seriously.Expectant management is feasible and effective in early onset severe preeclampsia,In the balance of maternal-fetal condition,expectant management can prolong gestation age and get better prenatal prognosis.During the expectant management,the situation of maternity and perinates should be closely monitored,and cesarean section in the first choice.There was important significance to strengthen circumnatal period health protection,It could reduce the morbility of preeclampsia and harmful effects.