Impact of recurrent preeclampsia on clinical manifestations and pregnancy outcomes
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摘要: 目的 探讨子痫前期(preeclampsia,PE)再发对病情及妊娠结局的影响。 方法 回顾性分析了2014年1月-2017年12月间安徽医科大学第一附属医院诊断PE并终止妊娠患者的临床资料,其中既往有PE病史的46例为再发组,同期首次诊断PE的56例为初发组。对比2组间、再发组2次患病的临床表现及妊娠结局的差异,并分析再发组2次患病间隔期的随访情况。 结果 再发组的重度PE和早发型PE的比例分别为91.30%、73.91%,初发组分别为73.21%、53.57%(均P<0.05)。再发组初次患病时早发型PE比例为32.61%,与再次患病的早发型比例差异有统计学意义(P<0.05)。再发组产妇的妊娠期肝肾功能异常率、胎儿超声脐血流异常率与前次患病及初发组差异均有统计学意义(均P<0.05),三者间的子痫、胎盘早剥的发生率差异无统计学意义(均P>0.05)。再发组诊断孕周比前次妊娠提前,新生儿体重及评分低于初发组(均P<0.05)。再发组前次妊娠终止后随访率为30.43%,再次妊娠时正规产检率为39.13%。 结论 PE再发时将比前次妊娠患病孕周提前,较初发组及前次患病时临床病情加重、妊娠结局不良。再发组产妇对疾病的认识不足、缺乏正规随访和产检。Abstract: Objective To investigate the impact of recurrent preeclampsia (PE) on clinical manifestations and pregnancy outcomes. Methods A retrospectively study on patients with preeclampsia terminated in our hospital from January 2014 to December 2017 was performed. The patients with a history of PE were assigned into recurrent group (n=46), and those without a history of PE were assigned into the first onset group (n=56). The clinical outcomes were analyzed between the two groups. We also analyzed some items within the recurrent preeclampsia group and the situation of interval period between the previous preeclampsia and the recurrent one. Results The proportions of severe PE and early onset PE were 91.30% and 73.92% in the recurrent group, while 73.21% and 53.57% in the first onset group (P<0.05). During the previous pregnancy in recurrent group, the proportion of early onset PE was 32.61%, which was different from the recurrent one (P<0.05). There were significant difference in the abnormal ratios of the visceral function and umbilical cord blood flow between the two groups (all P<0.05), so as to compare with the ratio of the last time attack. But the ratios of eclampsia, placental abruption and the amount of postpartum bleeding were the same (all P>0.05). The recurrent group had earlier onset weeks than the last time attack, and also had lower birth weight and Apgar score than those in the first onset group. The fellow-up rate after the previous PE was 30.43%, and the regular examination during the second pregnancy was 39.31%. Conclusion The onset recurrent preeclampsia usually occurs early as compare with its last time onset and the first onset patients, with more serious clinical condition and poor pregnancy outcomes. The patients who have recurrent preeclampsia usually pay less attention on the disease, and lack of regular follow-up and prenatal examination.
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Key words:
- Preeclampsia /
- Recurrence /
- Pregnancy outcomes /
- Clinical manifestations
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