子痫的特征与结局：两个时代的比较
Eclampsia characteristics and outcomes: a comparison of two eras.
作者信息
Schenone Mauro H, Miller Dorothy, Samson Jacques E, Mari Giancarlo
机构信息
Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
出版信息
J Pregnancy. 2013;2013:826045. doi: 10.1155/2013/826045. Epub 2013 Apr 7.
OBJECTIVE
To describe the trends in incidence, characteristics, and outcomes of women with eclampsia.
METHODS
We reviewed and abstracted data from medical records of all women diagnosed with eclampsia in our institution from August 1998 to April 2011. In addition to overall characteristics and outcomes, the cases were stratified by onset: antenatal versus postnatal and early (<32 weeks of gestation) versus late antenatal cases (≥32 weeks of gestation). Comparisons were made using chi-square, Fisher's exact, Mann-Whitney U, and t-tests. A two-sided P < 0.05 was considered statistically significant.
RESULTS
We identified 87 eclampsia cases out of 59,388 deliveries; 62 cases were diagnosed before delivery, and 25 had a postnatal onset. Among the 62 antenatal cases, 41 were diagnosed before 32 weeks and 21 at or after 32 weeks of gestation. Antenatal cases had higher systolic (P = 0.03) and diastolic (P = 0.01) blood pressures, more abnormal dipstick-test proteinuria (P = 0.002), and lower platelet counts (P ≤ 0.001) than postnatal cases. Early eclampsia cases were complicated more often with HELLP syndrome than late eclampsia cases (P = 0.007).
CONCLUSION
The occurrence of eclampsia has decreased over time. The earlier the onset is, the worse the outcome appears to be.
目的
描述子痫女性的发病率、特征及结局的变化趋势。
方法
我们回顾并提取了1998年8月至2011年4月在我院诊断为子痫的所有女性的病历资料。除了总体特征和结局外，病例按发病时间分层：产前与产后，以及早期（妊娠<32周）与晚期产前病例（妊娠≥32周）。采用卡方检验、Fisher精确检验、Mann-Whitney U检验和t检验进行比较。双侧P<0.05被认为具有统计学意义。
结果
在59388例分娩中，我们确定了87例子痫病例；62例在分娩前被诊断，25例产后发病。在62例产前病例中，41例在妊娠32周前被诊断，21例在妊娠32周及以后被诊断。产前病例的收缩压（P = 0.03）和舒张压（P = 0.01）较高，尿试纸法蛋白尿异常更多（P = 0.002），血小板计数较低（P≤0.001）。与晚期子痫病例相比，早期子痫病例更常并发HELLP综合征（P = 0.007）。
结论
子痫的发生率随时间下降。发病越早，结局似乎越差。
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