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早产和足月子痫前期:生化参数和妊娠结局的差异。

Preterm and term preeclampsia: differences in biochemical parameter and pregnancy outcomes.

机构信息

a Department of Obstetrics and Gynecology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , Jiangsu , China.

出版信息

Postgrad Med. 2018 Nov;130(8):703-707. doi: 10.1080/00325481.2018.1527169. Epub 2018 Oct 3.

Abstract

OBJECTIVE

To analyze the similarities and differences in the clinical parameters, laboratory biomarkers, and pregnancy outcomes between preterm and term preeclampsia (PE).

METHODS

Data on 185 women diagnosed with PE were collected from a Jiangsu Province Hospital from January 2017 to December 2017 and analyzed. 74 (40%) patients were diagnosed with preterm PE, of which 70 (94.6%) patients with PE with severe features (PEs) and the rest with PE. 111 (60%) patients were diagnosed with term PE, of which 54 (48.6%) patients with PEs and the rest with PE.

RESULTS

Preterm PE group had significantly higher blood pressure than that of term PE, with mean delivery at gestational age of 34.3[Formula: see text]2.1 weeks for preterm PE and 39[Formula: see text]1.2 weeks for term PE. Preterm PE group was associated with previous cesarean section and PE history, fetal growth restriction (FGR), non-reassuring fetal status (NRFS), and fetal umbilical artery (UA) systolic velocity/diastolic velocity ratio (S/D R) abnormality, neonatal lower birth weight, lower APGAR score, and higher NICU transfer rate. 74.3% of pregnant women from preterm PE group had proteinuria of +2 to +4, whilst only 37.8% pregnant women from term PE group developed that condition. Liver and renal function, also serum Ca and K were significantly higher in preterm PE.

CONCLUSION

Our study found that preterm PE significantly correlated with higher incidence of PEs, neonatal morbidities, also higher liver and kidney function compared to term PE. These results may be helpful for obstetricians to make accurate quantification of risk regarding every result of antenatal check-up, and perform close follow up if any abnormalities were found on blood pressure, ultrasound, or blood tests.

摘要

目的

分析早产子痫前期(PE)与足月 PE 在临床参数、实验室生物标志物和妊娠结局方面的异同。

方法

收集了 2017 年 1 月至 2017 年 12 月江苏省某医院 185 例 PE 患者的临床资料,对其进行回顾性分析。其中早产 PE 患者 74 例(40%),70 例(94.6%)为重度 PE,其余为轻度 PE;足月 PE 患者 111 例(60%),54 例(48.6%)为重度 PE,其余为轻度 PE。

结果

早产 PE 组的血压明显高于足月 PE 组,平均分娩孕周为 34.3[Formula: see text]2.1 周,足月 PE 组为 39[Formula: see text]1.2 周。早产 PE 组与剖宫产史、PE 史、胎儿生长受限(FGR)、非胎儿监护不良(NRFS)、胎儿脐动脉(UA)收缩期速度/舒张末期速度比(S/D R)异常、新生儿出生体重低、新生儿 Apgar 评分低、NICU 转率高有关。早产 PE 组孕妇蛋白尿为+2 至+4 者占 74.3%,而足月 PE 组仅占 37.8%。早产 PE 组肝肾功能及血清 Ca、K 明显高于足月 PE 组。

结论

本研究发现,与足月 PE 相比,早产 PE 与更高的重度 PE 发生率、新生儿发病率以及更高的肝肾功能有关。这些结果可能有助于产科医生对产前检查的每一个结果进行准确的风险量化,并在发现血压、超声或血液检查异常时进行密切随访。

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