中国实用妇科与产科杂志2018，Vol.34Issue(2)：190-194,5.DOI:10.19538/j.fk2018020116
重度子痫前期分娩安全性的多中心研究
Delivery mode and time of the women complicated with severe preeclampsia in China : a multicentre survey
摘要
Abstract
Objective To analyze the mode and time of delivery of the pregnant women complicated with severe preeclampsia in China.Methods Totally 2516 singleton pregnant women who were diagnosed with severe preeclampsia in 37 hospitals (including 20 tertiary hospitals and 17 secondary hospital) in 14 provinces from January 1 to December 31 in 2011 were selected by a cross sectional survey.These cases were divided into two groups according to the mode of delivery (the cesarean section group and the vaginal delivery group),and into five groups according to the delivery weeks (group Ⅰ less than or equal to 27+6 weeks,group Ⅱ 28-31+6 weeks,group Ⅲ 32-33+6 weeks,group Ⅳ 34-36+6 weeks and group Ⅴ more than or equal to 37 weeks).Results (1) The mode of delivery:the cesarean section rate was 84.9％ while the vaginal delivery rate was 15.1％.The rates of vaginal delivery in different gestational weeks were different (70.0％ vs.30.0％,28.7％ vs.71.3％,11.1％ vs.88.9％,6.6％ vs.93.4％,14.7％ vs.84.9％,P＜0.05).(2)The effect of the delivery mode and time on the pregnant women:the rate of postpartum hemorrhage and maternal mortality was almost the same in the different delivery mode groups.(5.3％ vs.5.6％,0.5％ vs.0.2％,P ＞ 0.05).There was no significant difference in the rate of postpartum hemorrhage in different delivery weeks (1.4％ vs.3.7％ vs.4.3％ vs.6.2％ vs.6.2％,P ＞ 0.05).The rates of postpartum hemorrhage were almost the same between the different delivery groups in group Ⅱ,Ⅲ,Ⅳ and Ⅴ (1.3％ vs.4.7％,3.2％ vs.4.4％,6.5％ vs.6.2％,7.9％ vs.5.8％,P ＞ 0.05).(3)The effect of the delivery mode and time on the neonates:the perinatal mortality in the cesarean section group was significantly lower than that in the vaginal delivery group (3.8％ vs.36.8％,P ＜ 0.05).There were no significant differences in the rate of the fetal distress or neonatal asphyxia between the different delivery mode groups (6.8％ vs.9.5％,0.5％ vs.0.2％,P ＞ 0.05).The incidences of fetal distress were the same between the different delivery mode group in each gestation week group (6.5％ vs.10.5％,9.7％ vs.16.1％,8.7％ vs.8.9％,7.9％ vs.8.2％,P ＞ 0.05).The rate of neonatal asphyxia in the cesarean group Ⅱ and Ⅲ was significantly higher than vaginal delivery group (48.7％ vs.15.6％,27.0％ vs.6.5％,P ＜ 0.05).The perinatal mortality in cesarean group Ⅱ,Ⅲ,and Ⅴ was significantly lower than the vaginal delivery group (14.7％ vs.75.3％,6.5％ vs.51.6％,2.3％ vs.28.3％,0.8％ vs.5.6％,P ＜ 0.05).Conclusion Pregnant women complicated with severe preeclampsia mostly delivery by cesarean section.Cesarean section does not reduce maternal complications such as postpartum hemorrhage and maternal death,but the perinatal mortality is lower in the cesarean section group.关键词
重度子痫前期/分娩方式/产后出血/围产儿死亡率Key words
severe preeclampsia/delivery mode/postpartum hemorrhage/perinatal mortality分类
医药卫生引用本文复制引用
伍绍文,李光辉,邹丽颖,陈奕,阮焱,张为远..重度子痫前期分娩安全性的多中心研究[J].中国实用妇科与产科杂志,2018,34(2):190-194,5.基金项目
国家卫计委卫生公益性行业科研专项(201002013) （201002013）
北京市优秀人才项目资助(2015000021469G214) （2015000021469G214）
北京市医院管理局“青苗”计划资助(QML20161401) （QML20161401）
首都医科大学附属北京妇产医院中青年学科骨干培养专项(fcyy201414) （fcyy201414）
