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子痫前期在前次及后续妊娠中的不良结局及复发风险

Adverse Outcomes of Preeclampsia in Previous and Subsequent Pregnancies and the Risk of Recurrence.

作者信息

Coban Ulas, Takmaz Taha, Unyeli Ozge Deniz, Ozdemir Savas

机构信息

Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Bezmialem University Faculty of Medicine, Istanbul, Turkey.

出版信息

Sisli Etfal Hastan Tıp Bul. 2021 Sep 24;55(3):426-431. doi: 10.14744/SEMB.2020.56650. eCollection 2021.

Abstract

OBJECTIVES

We evaluated the fetal and maternal outcomes of pregnant women with preeclampsia who gave birth in our hospital; we also evaluated preeclampsia recurrence rates in these patients and their fetal and maternal outcomes in their subsequent pregnancy.

METHODS

In this retrospective cohort study, 126 patients whose medical records were accessed completely and who got pregnant again and gave birth in our hospital were analyzed. The primary aim was to show the recurrence rate of preeclampsia, while the secondary aim was to evaluate the maternal and fetal results of the first pregnancy in which preeclampsia developed and the subsequent pregnancy.

RESULTS

The incidence of preeclampsia was found to be 2.1% in our clinic. The first pregnancy in which preeclampsia developed; 111 (80.2%) pregnancies resulted in a live birth, 7 (5.6%) resulted in termination, and 8 (6.3%) resulted in stillbirth. Neonatal death occurred in 10 (7.9%) pregnancies. While 105 of the subsequent pregnancies resulted in a live birth, 10 (7.9%) resulted in abortion, 9 (7.1%) resulted in stillbirth, and 2 (1.6%) resulted in termination due to preeclampsia. Neonatal death developed in 3 (2.6%) pregnancies. In the subsequent pregnancy, preeclampsia developed in 70 (55.5%) patients and 39 (55.7%) of these had preeclampsia with severe features.

CONCLUSION

The present study guides us on the risk factors related to preeclampsia and the rate of fetomaternal adverse outcomes and emphasizes the need for strict and regular antenatal follow-up in the subsequent pregnancies of women who have a history preeclampsia. Improvement of maternal and fetal morbidity and mortality in this way is the utmost goal.

摘要

目的

我们评估了在我院分娩的子痫前期孕妇的胎儿和母亲结局;我们还评估了这些患者子痫前期的复发率以及她们再次妊娠时的胎儿和母亲结局。

方法

在这项回顾性队列研究中,分析了126例病历资料完整且再次在我院怀孕并分娩的患者。主要目的是显示子痫前期的复发率,次要目的是评估首次发生子痫前期妊娠以及再次妊娠时的母婴结局。

结果

在我们的诊所中,子痫前期的发生率为2.1%。首次发生子痫前期的妊娠中,111例(80.2%)妊娠分娩活婴,7例(5.6%)妊娠终止,8例(6.3%)妊娠死产。10例(7.9%)妊娠发生新生儿死亡。在再次妊娠中,105例妊娠分娩活婴,10例(7.9%)妊娠流产,9例(7.1%)妊娠死产,2例(1.6%)因子痫前期妊娠终止。3例(2.6%)妊娠发生新生儿死亡。在再次妊娠中,70例(55.5%)患者发生子痫前期,其中39例(55.7%)为重度子痫前期。

结论

本研究为我们提供了与子痫前期相关的危险因素以及母婴不良结局发生率的指导,并强调了有子痫前期病史的女性再次妊娠时进行严格定期产前随访的必要性。以此改善母婴发病率和死亡率是首要目标。

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