Analysis Of Maternal And Perinatal Outcome In Early Onset Severe Preeclampsia

Objective: To explore the appropriate termination time and way ofwomen with early onset severe preeclampsia by investigating the relationsbetween the clinical characteristics and maternal and perinatal outcome;Method:106patients with early onset severe preeclampsia wereretrospectively reviewed in the second hospital of Jilin University．Patientswere divided into4groups: group A with onset before28weeks of gestation,group B with onset during28+1-30weeks of gestation, group C with onsetduring30+1-32weeks of gestation, and group D with onset during32+1-34weeksof gestation. Main outcome measures included prolongation of gestation,complications, perinatal outcomes, the prognosis of maternal and newbornbabies.Results:(1) The smaller the gestational weeks in early onset severepreeclampsia,the higher the maternal complication rates,but there was nosignificant difference among the gestational week groups，P=0.285. Amongthem, the pregnant women with hypoalbuminemia, the average rate was76.4%,followed by kidney and liver damage.(2) The difference of baby survival rateamong A, B and C was not statistically significant (P>0.05), but D groupcompared, the difference was statistically significant (P <0.05).(3) Betweenthe4groups who’s the induced labor rate quite P=0.000, a significantdifference. The induced labor rate of Group A compared with group C and Di ssignificant, P=0.004and0.002. Group B that’s the rate and C and D inducedlabor group there were significant differences, P=0.010and0.011. There is nodifference between group A and B. The cesarean section rate between the4groups was A<B<C<D, P=0.004, there was A significant difference. GroupA and C group of cesarean section rate was P=0.042, A group and group D cesarean section rate was more P=0.001, A significant difference.(4)follow-up of the time after discharge blood pressure returned to140/90mmHg,The bigger the gestational weeks in early onset severe preeclampsia,1monthsthe percentage of blood pressure returned to normal, the higher the betterprognosis, and the comparison between the group with a statistical significance.There was a statistical significance among the gestational week groups4groups over3months of urine protein turn into negative.Conclusion:(1) From the perinatal Outcome into consideration,32-34gestational age at the survival rate of up to86.0%of babies, and compared withbefore32weeks of pregnancy group have obvious difference, neonataloutcome improved, postpartum blood pressure recovery time and urine proteinnegativity before time is32of significantly reduced group, may consider theonset of EOSP gestational age defined gestational age at32.(2) The therapyprocess should follow the principle of individual. The onset of EOSP before28weeks of gestation should to be cautious when giving expectant treatment,short-term adept looking forward to treatment, if condition is poor control,appropriate termination of gestation in time, termination of pregnancy choiceshould be cautious when cesarean section, pregnant women in illness allow tryto choose the induced labor vaginal delivery operation. For28-30gestationalage at patients in the process of treatment fetus once appear within the distressor serious illness or limited growth when pregnant women not stable, cases ofserious complications, and far from32gestational age, should consider toterminate treatment; If condition is stable, as far as possible to maintainpregnancy to34weeks after pregnancy. For32weeks-34weeks of onset ofmaternal no termination of pregnancy is indications in level3medicalinstitutions closely monitored extend as far as possible with the thoughtful34weeks, neonatal outcome can be improved obviously, before the termination ofpregnancy first assess the situation of the mother can tolerate prolonged duration, the birth canal conditions could meet the requirements of prematureand shorten patients on whether the fetus positive attitude of the treatment, inroutine use of promoting child lung mature after treatment, the operationselective induced labor, the rest of the patients with cesarean section is as themain way termination of pregnancy.(3) The smaller the gestational weeks inearly onset severe preeclampsia, the slower blood pressure recovery and andurine protein negativity, the worse maternal prognosis.