Influence Of Different Termination Times Of Pregnancy On The Outcome Of Maternal And Infant In Early Onset Severe Preeclampsia

Objective: To study the effect of different termination times of pregnancy and childbirthways in early onset severe preeclampsia on the perinatal outcomes．We also compare the effectsof different gestation age to the outcome of maternal and infant. This study will provide referencefor clinical diagnosis and treatment for early onset severe preeclampsia pregnant women andperinatal infant.Method:1. Research methods and objectUsing retrospective analysis, we selected87patients with early onset severe preeclampsia inthe first affiliated hospital of Dalian Medical University from June of2004to August of2013. Wedivided into3groups according to the termination times of pregnancy: group A with a terminationtime of less than32weeks,26cases; group B with a termination time of32-33+6weeks,24cases;and group C with a termination time more than34weeks,37cases. We analyzed the pregnancyprolongation, childbirth ways,and the outcome of perinatal infant as well as majorcomplications.2. Research contentsRecord the general information of the three groups of pregnant women (Age, gestational age,gravidity, pregnancy prolongation), the blood pressure of admission, the blood pressure duringthe termination of pregnancy, prolongation of gestation, the24hours urinary protein ofadmission and during the termination of pregnancy, as well as the pregnancy complication, the outcome of pregnancy, childbirth ways, the birth weight of neonatal infant, APGAR score,perinatal complication. We compare the difference of the pregnancy complication and theperinatal outcome in these three groups.Results:1. The differences of the age, gravidity and parity of pregnant women in Group A, B and Cwere found to be statistically insignificant (P>0.05).2.There were significant difference in the onset of gestational age of preeclampsia onsetamong the three groups (P<0.05), further analysis between groups, no statistical difference wasobserved between Group B and C(P>0.05);The pregnancy week of group A was less than group Band C.(P<0.05)3. There were significant difference in the pregnancy prolongation among the three groups,group A、B <group C (P<0.05).，no statistical difference was observed between Group A andB(P>0.05).4. There were significant difference in the rate of surgical delivery among the three groups,group B、C> A (P<0.05). No difference between Group B and C.5. There were no significant difference in the blood pressure of admission or during thetermination of pregnancy among the three groups(P>0.05),Compare to24hours urinary protein ofadmission, the24hours urinary protein during the termination of pregnancy has raised(P<0.05),Among the three groups: urine protein of group C <A (P<0.05)6. Although the group A variety of serious complications, and its incidence is substantiallyhigher than B, C groups. But statistical analysis shows: There were no significant difference in thepregnancy complication in Group A, B and C(P>0.05)。7.There were no significant differences in the fetal growth restriction of perinatal infantcomplications，as well as the incidence of intrauterine fetal death (P>0.05); Although theincidence of fetal distress decreased from A to C groups, statistical analysis showed that the threegroups of fetal distress was no statistically significant (P>0.05). The perinatal mortality of groupA was significant greater than that of group B and group C (P<0.05). There was significantdifference in the mild neonatal asphyxia, and severe neonatal asphyxia: group A<B、C (P<0.05). Conclusion:1. The early onset severe preeclampsia was early onset and severe, with many gestationalcomplications and multiple organ dysfunction.2. There is a high maternal and perinatal mortality.It is a severe threatening disease tomaternal and fetus health. In the premise of maternal-safety, expectant management resulting inan ideal maternal-fetal outcome by extending gestational age and improving fetal maturity.3. It is especially important to monitor and control of blood pressure for early onset severepreeclampsia after admission. By antispasmodic and antihypertensive therapy, the blood pressurecan be controlled well.4. In the early onset severe preeclampsia disease, the24hours urinary protein tended toincrease during treatment, there is reference value to the disease, but it can not serve as the soleindication of termination of pregnancy. We should be based on patients condition through acomprehensive assessment of female and fetus，so that can we make a decision to terminate thepregnancy.5. The early onset severe preeclampsia easy to combined serious complications, with thetermination of the extension of time of pregnancy, maternal complication rates decline.6. Before34weeks of gestation, with the increased termination of pregnancy gestational age,perinatal child mortality, fetal distress and neonatal asphyxia rate gradually decreased, showingthat early onset severe preeclampsia was extended to34weeks can be get better maternaloutcome.7. Termination of pregnancy after32weeks based cesarean section.