Clinical Retrospective Analysis Of 131 Cases Of Characteristics And Management Of Early-onset Severe Preeclampsia

Objective To explore the clinical characteristics of early-onset server preeclampsia,and the impact on the maternal morbidities and perinatal outcome based on gestational age (GA) at the onset of early-onset and later-onset severe preeclampsia.Methods This was a retrospective analysis of outcome in 131 patients with severe preeclampsia. They were classified according to gestational age on admission into three groups. Group A included 43 patients with gestational ages before 32weeks. Group B (32 to 34weeks) included 38 patients and group C (>34weeks) included 50 patients. Outcome measures included blood pressure and gestational ages on admission, prolongation of gestation, maternal symptoms, maternal and perinatal complications.Results 1.There were no significant differences in the age and parity of the studied women, blood pressure on admission, and prolongation of gestation among the 3 groups at each gestational age.There were significant differences in the gestational ages on admission and gestational ages on delivery among the 3 groups.2.There were no significant differences in the rate of maternal symptoms among the 3 groups including headache,diziness,dim eyesight,nausea, emesia, epigastric discomfort and edema(≥3+). Edema (≥3+) was the most frequent symptom (33.3%),followed by dim eyesight (30.53%).4. Hypoproteinemia is the most frequent maternal complication (83.2%), followed by sign of ascites (30.5%).There were significant differences in maternal complications among the 3 groups including hypoproteinemia and HELLP syndrome, and there were no significant differences in sigh of ascites, elevated liver enzymes or low platelets.There is no pulmonary edema or hypertensive encephalopathy occurred.4.The rate of fetal death and stillbirth in group A was 17.4%, compared with group C, it was significantly higher (P<0.01).There was a significant decrease in the rate of neonatal asphyxia with advanced gestational age (P<0.05).Conclusion Compared with late-onset severe preeclampsia developing near term, early-onset severe preeclampsia developing remote from term, is associated with a relatively higher rate of maternal morbidity and perinatal mortality.The rate of fetal death and stillbirth is significantly higher before 32 weeks, and the rates of very low birth weight infant, extremely low birth weight infant and neonatal asphyxia, which are associated with unfavorable neonatal outcome.There is no significant difference in the rate of extremely low birth weight infant between the group 32～34 weeks and the group after 34 weeks, and the difference in the rate of neonatal asphyxia is decreased.