Comparative Observation On The Effect Of Early Onset And Late Onset Severe Preeclampsia On Maternal And Neonatal Outcomes

Objective: To compare the early and late onset severe preeclampsia maternal complications, influence on perinatal outcome and mode of termination of pregnancy; to investigate the effect of ES-PE on maternal and neonatal outcomes, to enhance the understanding and treatment of ES-PE.Methods: retrospective analysis of the case from 2000 June to 2014 October in the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Dalian Medical University, the clinical data of 95 cases of severe preeclampsia patients were studied. According to gestational weeks were divided into A and B two groups, less than 32 weeks of gestation for group A is the early onset severe preeclampsia group, a total of 42 cases, the age distribution in the range 20-42 years old, the average age is(31.07 + 5.42) years old; more than 32 weeks of gestation for group B is late onset severe preeclampsia group, a total of 53 cases, the age distribution in the range 24-43 years, the average age(31 + 4.18) years old. Two groups of patients were positive for sedation, spasmolysis, step-down, nutritional support and promote fetal lung maturation, and close monitoring of the mother and the fetus, timely termination of pregnancy; After 48 hours of active treatment,if the patient’s condition is not improved or continue to deteriorate, timely termination of pregnancy is needed. SPSS 17 software is selected for statistical analysis. The mean and the standard deviationis is selected to express measurement data, such as age, blood pressure, the incidence of pregnancy week; Chi square test and continuity corrected chi square test are used to analysis of count data,such as placental abruption, organ damage, hypoproteinemia, ocular fundus disease, fetal growth restriction, fetal distress, fetal death and so on. There were statistically significant differences in P<0.05. The two groups were observed and compared with maternal complications occurrence rate and perinatal outcomes, to understand the impact of early and late onset severe preeclampsia on maternal and neonatal outcomes.Results:1.The systolic and diastolic blood pressure of the early-onset group compared with the late onset group, ES-PE group were higher than LOSP group,the difference was significant(P < 0.05); Comparing the time of termination of pregnancy, there was significant difference between two groups(P < 0.05); Compare the maternal complications,the incidence of placental abruption, HELLP syndrome, liver and kidney damage, retinopathy, hypoproteinemia was higher in the ES-PE group,There were statistically significant between two groups(P < 0.05).2. Perinatal outcome comparison between two groups, the incidence of neonatal asphyxia and fetal distress, fetal death rate was significantly higher in the ES-PE group, the incidence of neonatal asphyxia was significantly different from the LOSP group(P < 0.05).3. Cesarean section is the main way of termination of pregnancy in the two group, cesarean section rate in group A was lower than that in group B, differences between the two groups was not significant(P>0.05).Conclusion: 1.Early onset severe preeclampsia had higher risks than late onset severe preeclampsia on the incidence of maternal complications,such as placental abruption, HELLP syndrome, liver and kidney damage, retinopathy, hypoproteinemia and so on.2. On the perinatal outcome, early onset severe preeclampsia was more prone to fetal distress, fetal death, neonatal asphyxia, compared with LOSP.3. Cesarean section is the main way of termination of pregnancy in early and late onset severe preeclampsia, but the cesarean section rate of ES-PE is lower than tthat of LOSP.