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妊娠期高血压患者的引产:一项重大的产科挑战。

Labour induction with gestational hypertension: A great obstetric challenge.

作者信息

Khaskheli Meharun-Nissa, Baloch Shahla, Sheeba Aneela, Baloch Sarmad, Khan Fahad

机构信息

Dr. Meharun-Nissa Khaskheli, MBBS, FCPS. Associate Professor, Dept. of Obstetrics & Gynaecology, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan.

Dr. Shahla Baloch, MBBS, DGO, FCPS. Associate Professor, Dept. of Obstetrics & Gynaecology Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan.

出版信息

Pak J Med Sci. 2017 Jan-Feb;33(1):151-155. doi: 10.12669/pjms.331.10386.

DOI:10.12669/pjms.331.10386
PMID:28367190
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5368298/
Abstract

OBJECTIVE

To observe the fetomaternal morbidity and mortality with induction of labour in pregnant women with gestational hypertension.

METHODS

The subjected study population included was 138 pregnant women with gestational hypertension. These pregnant women were between 34-40 weeks of gestational period in whom labour was induced, while the pregnant women who had labour induction for other reasons were excluded. These women were registered on the predesigned proforma. The data was collected and analyzed on SPSS version 21.

RESULT

Out of the 138 cases, mean age of the women was 25.93±5.037, prim gravid women were 78(56.5%), gestational period in majority of these women 71(51.4%) varied between 35-38 weeks. The common presenting symptoms were oedema 119(86.23%), headache 90(65.21%). Labour induction in majority of the cases 81(58.7%) was carried with prosten pessary. The Caesarean section was needed in 39(28.3%) women in emergency due to maternal and fetal reasons or due to failed induction. Maternal complications were uncontrolled hypertension 23(16.7%), intensive care unit admission 21(15.2%), fits 15(10.9%), post partum haemorrhage 13(9.4%). Fetal complications were birth asphyxia 49(35.5%), neonatal intensive care unit admission 17(12.3%), neonatal death 14(10.1%).

CONCLUSION

The emergency Caesarean section rate was quite high with induction of labour in pregnant women with gestational diabetes. The maternal morbidity as well as fetal morbidity and mortality rate was also high.

摘要

目的

观察妊娠期高血压孕妇引产时的母儿发病率及死亡率。

方法

纳入研究的对象为138例妊娠期高血压孕妇。这些孕妇孕周在34 - 40周之间,均接受引产,排除因其他原因引产的孕妇。这些孕妇在预先设计的表格上进行登记。数据采用SPSS 21版进行收集和分析。

结果

138例患者中,女性平均年龄为25.93±5.037岁,初产妇78例(56.5%),其中大多数71例(51.4%)孕周在35 - 38周之间。常见症状为水肿119例(86.23%)、头痛90例(65.21%)。大多数81例(58.7%)病例采用普罗斯特阴道栓引产。39例(28.3%)产妇因母胎原因或引产失败而急诊行剖宫产。产妇并发症包括血压控制不佳23例(16.7%)、入住重症监护病房21例(15.2%)、抽搐15例(10.9%)、产后出血13例(9.4%)。胎儿并发症包括出生窒息49例(35.5%)、新生儿入住重症监护病房17例(12.3%)、新生儿死亡14例(10.1%)。

结论

妊娠期糖尿病孕妇引产时急诊剖宫产率相当高。母儿发病率及死亡率也较高。

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Am J Obstet Gynecol. 2012 Sep;207(3):214.e1-6. doi: 10.1016/j.ajog.2012.06.009. Epub 2012 Jun 11.
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Should cervical favourability play a role in the decision for labour induction in gestational hypertension or mild pre-eclampsia at term? An exploratory analysis of the HYPITAT trial.宫颈成熟度在足月妊娠合并高血压或轻度子痫前期行引产中的作用?HYPITAT 试验的探索性分析。
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Semin Perinatol. 2011 Oct;35(5):292-6. doi: 10.1053/j.semperi.2011.05.010.
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