Hall D R, Odendaal H J, Steyn D W, Grové D
Department of Obstetrics and Gynaecology, Tygerberg Hospital and University of Stellenbosch, South Africa.
BJOG. 2000 Oct;107(10):1252-7. doi: 10.1111/j.1471-0528.2000.tb11616.x.
To evaluate the safety and outcome of women undergoing expectant management of early onset, severe pre-eclampsia.
Prospective case series extending over a five-year period.
Tygerberg Hospital, a tertiary referral centre.
All women (n = 340) presenting with early onset, severe pre-eclampsia, where both the mother and the fetus were otherwise stable.
Frequent clinical and biochemical monitoring of maternal status, together with careful blood pressure control, in a high care obstetric ward.
Major maternal complications and prolongation of gestation.
Multigravid women constituted 67% of the group. Antenatal biochemistry was reassuring with some expected, but not severe, deteriorations. Twenty-seven percent of women experienced a major complication, but few had poor outcomes. No maternal deaths occurred. Most major complications resolved quickly, necessitating only three admissions (0.8%) to the intensive care unit. One woman required dialysis. Pregnancies were prolonged by a mean (median) number of 11 days (9) before delivery, with more time being gained at earlier gestations. The postpartum inpatient stay (89% < or =7 days, bearing in mind that 82% of women were delivered by caesarean section) was not extended.
Careful noninvasive management of early onset, severe pre-eclampsia in a tertiary centre can diminish and limit the impact of serious maternal complications. Valuable time to prolong the pregnancy and improve neonatal outcome is thereby gained.
评估早发型重度子痫前期患者期待治疗的安全性及结局。
为期五年的前瞻性病例系列研究。
三级转诊中心泰格堡医院。
所有早发型重度子痫前期患者（n = 340），其母胎情况均稳定。
在产科重症监护病房对孕妇进行频繁的临床及生化监测，并严格控制血压。
主要的孕产妇并发症及孕周延长情况。
该组中经产妇占67%。产前生化指标虽有一些预期但并不严重的恶化，但仍令人放心。27%的患者出现了主要并发症，但很少有不良结局。无孕产妇死亡发生。大多数主要并发症迅速缓解，仅0.8%（3例）患者需入住重症监护病房。1例患者需要透析治疗。分娩前孕周平均（中位数）延长11天（9天），孕早期延长时间更多。产后住院时间（89%≤7天，需注意82%的患者通过剖宫产分娩）未延长。
在三级医疗中心对早发型重度子痫前期进行仔细的非侵入性管理，可减少并限制严重孕产妇并发症的影响，从而赢得延长孕周及改善新生儿结局的宝贵时间。
