曼苏拉大学医院重度子痫前期的孕产妇、胎儿和新生儿结局:一项前瞻性研究

Rana Mostafa EL-Adl, Mohamed Eid, H. Shalan, Mohamed M. Hussien
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摘要

背景:先兆子痫继续影响全世界5%至8%的妊娠。它是一种妊娠特异性多系统疾病,是孕产妇和围产期发病率和死亡率的主要原因。子痫前期的确切发病机制仍不清楚。重度子痫前期的特征包括严重蛋白尿、高血压、中枢神经系统功能障碍、肝细胞损伤、血小板减少、少尿、肺水肿、脑血管意外和IUGR。患有严重先兆子痫的妇女必须住院以稳定病情。工作目的:评价曼苏拉大学附属医院重度子痫前期患儿的母、胎、新生儿结局。方法:这是一项为期一年的前瞻性研究,时间为2019年9月至2020年9月,纳入了曼苏拉大学附属医院妇产科收治的所有重度先兆子痫孕妇。结果:本研究纳入204例患者。产妇结局方面,胎盘早剥、急性肾功能衰竭、ICU入院率、DIC、HELLP和PPH分别为7.8%、4.9%、15.7%、0.5%、8.3%和3.4%。考虑到胎儿结局,13%的病例发生IUGR, 13%的病例以IUFD结束。在新生儿结局方面,早产、新生儿重症监护病房入院低APGAR评分的比例分别为69%、62%和47%。胎龄是唯一影响IUFD发生率、NICU入院率和低APGAR评分的显著因素(P<0.001)。结论:先兆子痫易危及孕产妇健康和胎儿生存能力,增加孕产妇和新生儿的死亡率和发病率。此外,胎龄是影响IUFD发生率、NICU入院率和低APGAR评分的唯一显著因素。曼苏拉医学杂志(曼苏拉医学院官方杂志)pISSN: 1110-211X;eISSN: 2735 - 3990
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Maternal,fetal and neonatal outcomes of severe preeclampsia in Mansoura University Hospitals: A prospective study
Background: Preeclampsia continues to affect 5% to 8% of all pregnancies throughout the world. It is a pregnancy-specific multisystem disorder and a leading cause of maternal and perinatal morbidity and mortality. The exact pathogenesis of preeclampsia remains poorly defined. Features of severe preeclampsia include severe proteinuria, hypertension, symptoms of central nervous system dysfunction, hepatocellular injury thrombocytopenia, oliguria, pulmonary edema, cerebrovascular accident, and IUGR. Women with severe preeclampsia must be hospitalized to try to stabilize the disease. Aim of work: To evaluate maternal, fetal and neonatal outcomes of severe preeclampsia in Mansoura university Hospitals. Methods: This was a prospective study for one year, from September 2019 till September 2020, included all gravid women with severe preeclampsia who were managed at Mansoura University hospitals, Department of Obstetrics and Gynecology. Results: This study included 204 patients. Regarding maternal outcomes, the percentages of Placental abruption, Acute renal failure, ICU admission, DIC, HELLP and PPH were 7.8%, 4.9%, 15.7%, 0.5%, 8.3% and 3.4%, respectively. Considering fetal outcomes, IUGR developed in 13% of cases, and 13% of cases ended with IUFD. With regard to neonatal outcomes, the percentages of preterm delivery, NICU admission low APGAR score were 69%, 62% and 47%, respectively. Gestational age was the only significant factor to affect incidence of IUFD, NICU admission and low APGAR score (P<0.001). Conclusion: Pre-eclampsia tends to threaten maternal health and fetal viability adding to maternal and neonatal mortality and morbidity. In addition, gestational age was the only significant factor to affect incidence of IUFD, NICU admission and low APGAR score. Mansoura Medical Journal (Official Journal of Mansoura Faculty of Medicine) pISSN: 1110-211X; eISSN: 2735-3990
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