| Objective: to retrospective analysis of clinical data about 123 cases patient with early onset severe preeclampsia, and research the factor termination of pregnancy with ESPE, expectant management, the prognosis of pregnant woman and fetus and situation of termination of pregnancy.Methods: retrospective analysis of ESPE clinical data about 123 cases of 28 th week of pregnancy or above to terminate the pregnancy.Results:The first study: patients can be divided into four groups according to different gestational age:group A(gestational age < 28 weeks), group B(28 weeks ≦gestational age<30 weeks), group C(30 weeks ≦gestational age<32 weeks), group D(32 weeks ≦gestational age<34 weeks).123 cases patients were diagnosed conforms to the standard of early onset severe preeclampsia,patients’ blood pressure about between 120 to 250 mm Hg or 70 to 170 mm Hg, and the age about 18 to 42 years old. To compare number of days of expectant management have significant difference of each group, group A(gestational age < 28 weeks) and number of days in 18 to 28 days of expectant management of maternal, group B(28 weeks ≦gestational age<30 weeks) and number of days in 10 to 15 days of expectant management of maternal,group C(30 weeks ≦gestational age<32 weeks) and number of days in 5 to 10 days of expectant management of maternal, group D(32 weeks ≦gestational age<34 weeks) and number of days in 3 to 7 days of expectant management of maternal, by compare of each group, and find that the more smaller of gestational age, the more longer of expectant management.The second study: Patients can be divided into four groups according to different gestational age of terminate the pregnancy: group a(28 weeks<gestational age<30 weeks), group b(30weeks<gestational age<32 weeks), group c(32weeks≦gestational age<36weeks), group d(gestational age≧36weeks); the group c again can be divided into 5 groups: groupⅠ(32weeks ≦ gestational age < 33 weeks), groupⅡ(33 weeks ≦gestational age<34 weeks),groupⅢ(34 weeks ≦gestational age<35 weeks), groupⅣ(35 weeks ≦gestational age<36weeks). All the maternal have no death, 21 cases of eclampsia, about17.07%, 53 cases of thrombocytopenia, about 43.09%, and 17 cases of placental abruption, about 13.82%, 14 cases of heart failure and about 11.38%, 21 cases of retinopathy and about 17.07%,9 cases of postpartum hemorrhage and about 7.32%,about 5.69% of HELLP syndrome,24 cases of hypoalbuminemia and about 19.51%,71 cases of placental function decline and about 57.72%.Maternal complications of the different opportunity of termination of pregnancy through statistical analysis, and get a conclusion: compared with four groups of a, b, c and d of maternal complications have statistical significance(P<0.05), to explore group a and group b,group c and group d of maternal complications there was no statistically significant difference in cases of clinical(P>0.05), and group a and group c, group a and group d, group b and group c, group b and group d of maternal complications that the difference was statistically significant in the clinical(P<0.05), group c of maternal complications there was no statistically significant difference(P > 0.05). Comparison between the four groups of maternal reason for termination of pregnancy, maternal factors in which occupy the important reasons. Termination of pregnancy of pregnant women and puerperal mainly reason is maternal factors, group c and group d have more fetal factors. There is statistically analysis about different groups: to compare reasons of termination of pregnancy of group a, b, c and d,there was a significant difference, four groups of the difference was statistically significant(P< 0.05), reasons of termination of pregnancy of group a and b, group c and d there was no significant difference(P>0.05), reasons of termination of pregnancy of group a and c, group a and d, group b and c, group b and d, the difference was statistically significant(P <0.05),comparison group c that there was no statistically significant difference(P > 0.05). After statistics, 12 cases of fetal intrauterine and about 9.76%, 2 cases of stillbirth and about 1.63%,neonatal death after giving birth to a child or to give up 14 cases, about 11.38%, total death 28 cases and about 22.76%, total death of group a have 9 cases and about 81.81%, death of group b have11 cases and about 64.71%, death of group c have 8 cases and about 9.64%, group d have no death cases. The apgar statistical analysis that on birth weight and immediately, 5minutes and 10 minutes four groups have significant statistical significance(P<0.05), group a and c, group a and d, group b and c, group b and d, group c and d comparison between the two groups the difference was statistically significant(P<0.05), group c neonatal birth weight have a significant statistical significance(P<0.05), while after birth, 5 minutes and 10 minutes apgar score comparison difference no significant statistical difference(P > 0.05). Prenatal complications and death occurred situation analysis and comparison of statistics: fetal distress and fetal intrauterine death and cause of stillbirth, there was no significant difference is statistically significant(P>0.05); after the birth of death and give up treatment difference was statistically significant(P<0.05).Conclusions: The first: Maternal factors are main reason of ESPE termination of pregnancy,and find that the longer of gestational age, the more obvious of the fetus and other factors.The second: Treatment time is 2 to 4 weeks of 4ESPE incidence week’s smaller than28 weeks,28 to 32 weeks around 1 to 1.5 weeks, 32 weeks after about a week or so. The third: The second researches found that group c of occurrence rate of maternal complications have no significant statistically, it is feasible that Clinical termination of pregnancy gestational age between 32 to 36 weeks. |
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