Pacher Juliane, Brix Eva, Lehner Rainer
Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, AKH, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Arch Gynecol Obstet. 2014 Feb;289(2):263-7. doi: 10.1007/s00404-013-2936-3. Epub 2013 Jul 13.
Preeclampsia is accompanied by high maternal and fetal morbidity and mortality. Thus, delivery needs to be planned carefully. The aim of this study was to determine the most favorable delivery for patients with preeclampsia between the week 37 and 41 of gestation.
For this retrospective study, patient data from 2003 to 2011 was collected. Study participants were women having a Cesarean section during week 37 and 41 of gestation. The population was classified into four groups: patients without hypertensive disorders having an elective or emergency Cesarean section and patients suffering from preeclampsia with elective or emergency Cesarean section. Analysis included mode of delivery and neonatal outcome, defined by Apgar score, rate of NICU admission and pH value of the umbilical cord.
A total of 130 cases of preeclampsia were recorded. Compared to the control group, we observed a significantly higher Apgar score in the study group with emergency Cesarean section. Furthermore, within the study group the Apgar score at 5 and 10 min was also significantly increased in cases delivered by emergency Cesarean section. Moreover, the pH value of the umbilical cord was significantly higher in the study group. Considering the delivery mode, significant differences were found in favor of the elective Cesarean section. There were no differences in the rate of NICU admission between the groups.
The most frequent mode of delivery for women suffering from preeclampsia is elective Cesarean section; however, neonates delivered by emergency Cesarean section did not show an adverse neonatal outcome.
子痫前期伴有较高的孕产妇和胎儿发病率及死亡率。因此，需要谨慎规划分娩。本研究的目的是确定妊娠37至41周子痫前期患者最适宜的分娩方式。
对于这项回顾性研究，收集了2003年至2011年的患者数据。研究参与者为在妊娠37至41周期间进行剖宫产的女性。人群分为四组：无高血压疾病行择期或急诊剖宫产的患者以及患有子痫前期行择期或急诊剖宫产的患者。分析包括分娩方式和新生儿结局，新生儿结局由阿氏评分、新生儿重症监护病房（NICU）入住率和脐带血pH值定义。
共记录了130例子痫前期病例。与对照组相比，我们观察到急诊剖宫产的研究组阿氏评分显著更高。此外，在研究组中，急诊剖宫产分娩的病例在5分钟和10分钟时的阿氏评分也显著升高。而且，研究组脐带血pH值显著更高。考虑到分娩方式，发现择期剖宫产更具显著优势。各组间NICU入住率无差异。
子痫前期女性最常见的分娩方式是择期剖宫产；然而，急诊剖宫产分娩的新生儿并未出现不良新生儿结局。
