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目的:探讨早发型重度子痫前期不同分娩方式与母儿结局关系。方法:采用回顾性非随机病例对照研究的方法,分析2010年6月至2012年6月武汉大学人民医院收治139例早发型重度子痫前期不宜期待的患者临床资料,按终止妊娠方式分为两组,A组COOK球囊促宫颈成熟并引产经阴道分娩,B组选择性剖宫产。比较两组间母儿预后情况,包括围生儿结局和母亲严重并发症的发生情况。结果:139例早发型重度子痫前期中A组41例选择引产后39例阴道分娩,B组98例未经阴道试产选择性剖宫产。两组新生儿窒息发生率、新生儿死亡率,孕妇并发症发生率无明显差异,产后出血率、差异有显著性。结论:早发型重度子痫前期引产后阴道分娩没有增加母婴并发症的发生率,而产后出血率及住院费用下降。选择COOK球囊促宫颈成熟并引产后经阴道分娩是可行的。
Objective: To investigate the relationship between different modes of delivery and maternal and infant outcomes in early-onset severe preeclampsia. Methods: A retrospective non-randomized case-control study was conducted to analyze the clinical data of 139 cases of patients with early-onset severe pre-eclampsia who were treated in Wuhan University People’s Hospital from June 2010 to June 2012. The data were divided into two according to termination of pregnancy Group, A group COOK balloon to promote cervical ripening and induced vaginal delivery, B group selective cesarean section. Maternal and child prognosis was compared between the two groups, including the outcome of perinatal and maternal serious complications. Results: In the 139 cases of early-onset severe preeclampsia, 41 cases of group A were given vaginal delivery after labor induction and 98 cases of group B received cesarean section without vaginal delivery. There was no significant difference in the incidence of neonatal asphyxia, neonatal mortality and maternal complications between the two groups. The rate of postpartum hemorrhage was significantly different. Conclusions: Vaginal delivery after early labor in preeclampsia with severe preeclampsia did not increase the incidence of maternal and infant complications, while the rate of postpartum hemorrhage and hospitalization decreased. Choose COOK balloon cervical ripening and vaginal delivery after induction of labor is feasible.