Ertekin Arif Aktuğ, Kapudere Bilge, Eken Meryem Kurek, İlhan Gülşah, Dırman Şükriye, Sargın Mehmet Akif, Deniz Engin, Karatekin Güner, Çöğendez Ebru, Api Murat
Faculty of Health Sciences-Istanbul, Uskudar University Turkey.
Department of Obstetrics and Gynaecology-Istanbul, Zeynep Kamil Women and Children Diseases, Education and Research Hospital Turkey.
Int J Clin Exp Med. 2015 Oct 15;8(10):19325-31. eCollection 2015.
To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy.
Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group.
The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (P > 0.05). Three neonatal complications in Group 2 and five in Group 1 were detected according to the Denver Developmental Screening Test-II and one pathologic case was detected in both groups following neurologic examination. Neonatal mortality was seen in seven patients in Group 1 and one in Group 2. There were no significant differences between groups in terms of neonatal mortality and morbidity and maternal morbidity (P > 0.05). The average latency period was 3.45 ± 5.48 days in Group 2 and none in Group 1.
There was no significant difference in the first year neurological development of infants whose mothers underwent either expectant and aggressive management for severe preeclampsia.
比较和评估重度子痫前期期待治疗与积极治疗对妊娠27至34周孕妇所产婴儿出生后第一年神经发育的影响。
本研究纳入70例妊娠27至34周的重度子痫前期患者。37例患者接受积极治疗（第1组），33例患者接受期待治疗（第2组）。两组均给予糖皮质激素、硫酸镁输注和降压药物。第1组在完成糖皮质激素给药后，通过剖宫产或阴道分娩。第2组在完成糖皮质激素给药后停止硫酸镁输注。继续给予降压药物，患者卧床休息并进行严密胎儿监测。
两组的平均孕周、1分钟和5分钟阿氏评分以及重症监护病房住院时间相似（P>0.05）。根据丹佛发育筛查测试-II，第2组检测到3例新生儿并发症，第1组检测到5例，神经检查后两组均检测到1例病理病例。第1组有7例患者出现新生儿死亡，第2组有1例。两组在新生儿死亡率、发病率和孕产妇发病率方面无显著差异（P>0.05）。第2组的平均潜伏期为3.45±5.48天，第1组无潜伏期。
对于重度子痫前期，母亲接受期待治疗或积极治疗的婴儿在出生后第一年的神经发育方面无显著差异。
