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[对入住产科重症监护病房的重度子痫前期、子痫或HELLP综合征患者的孕产妇发病率和死亡率分析]

[Analysis of maternal morbidity and mortality among patients admitted to Obstetric Intensive Care with severe preeclampsia, eclampsia or HELLP syndrome].

作者信息

Curiel-Balsera E, Prieto-Palomino M A, Muñoz-Bono J, Ruiz de Elvira M J, Galeas J L, Quesada García G

机构信息

Unidad de Cuidados Intensivos Maternal, Hospital Regional Universitario Carlos Haya, Málaga, España.

出版信息

Med Intensiva. 2011 Nov;35(8):478-83. doi: 10.1016/j.medin.2011.05.011. Epub 2011 Jun 23.

DOI:10.1016/j.medin.2011.05.011
PMID:21703718
Abstract

OBJECTIVE

To describe the incidence and clinical and epidemiological profile of patients with severe preeclampsia admitted to Intensive Care.

DESIGN

A prospective, observational case series.

SETTING

A specific obstetric 8-bed ICU belonging to a university hospital with a total of 55 ICU beds.

PATIENTS

A total of 262 patients admitted due to severe preeclampsia, eclampsia or HELLP syndrome.

INTERVENTION

Descriptive analysis of the population and complications in the ICU and hospital mortality.

RESULTS

The mean patient age was 30.47±5.7 years, with the following diagnóstico at admission: A total of 78% of the patients with severe preeclampsia, 16% with HELLP syndrome, and 6% with eclampsia, occurring in gestational week 31.85±4.45. In turn, 63% of the patients were nulliparous and had a low prevalence of previous diseases. The global complications rate was 14% (9% heart failure, 5% acute renal failure and 2% coagulopathy). Maternal mortality was 1.5% (4 patients), and was associated with non-nulliparous status, the presence of complications, and toast > 71mg/dl.

CONCLUSIONS

Severe preeclampsia has a low mortality rate (1.5%), though the complications rate is considerable (14%). The condition develops more often in nulliparous women during the third trimester of pregnancy.

摘要

目的

描述入住重症监护病房的重度子痫前期患者的发病率、临床和流行病学特征。

设计

前瞻性观察病例系列研究。

地点

一所大学医院中设有8张床位的特定产科重症监护病房,该医院共有55张重症监护病床。

患者

共有262例因重度子痫前期、子痫或HELLP综合征入院的患者。

干预措施

对该人群进行描述性分析,并分析重症监护病房内的并发症及医院死亡率。

结果

患者平均年龄为30.47±5.7岁,入院时诊断情况如下:重度子痫前期患者占78%,HELLP综合征患者占16%,子痫患者占6%,发病孕周为31.85±4.45周。此外,63%的患者为初产妇,既往疾病患病率较低。总体并发症发生率为14%(心力衰竭9%,急性肾衰竭5%,凝血病2%)。孕产妇死亡率为1.5%(4例患者),与非初产妇状态、存在并发症以及血糖>71mg/dl有关。

结论

重度子痫前期死亡率较低(1.5%),但并发症发生率较高(14%)。该病在初产妇妊娠晚期更为常见。

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