Visser W, van Pampus M G, Treffers P E, Wallenburg H C
Department of Obstetrics and Gynaecology, Erasmus University School of Medicine and Health Sciences, Rotterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1994 Mar 15;53(3):175-81. doi: 10.1016/0028-2243(94)90116-3.
To evaluate maternal and perinatal outcome of hemodynamic temporizing management in severe pre-eclampsia.
Study group of 57 pre-eclamptic women, gestational age 35 weeks or less, treated with plasma volume expansion and vasodilatation under invasive hemodynamic monitoring, retrospectively matched with a control group treated in another center without volume expansion and invasive monitoring.
In both groups pregnancy was prolonged with 10-11 days. Maternal morbidity was low in both groups. No complications of hemodynamic monitoring were observed. Perinatal mortality was not significantly different between the study group (7.1%) and the control group (14.3%). SGA-infants were significantly less frequent in the study group (9%) than in controls (33%).
Temporizing treatment of patients with early severe pre-eclampsia, with or without plasma volume expansion and invasive hemodynamic monitoring, may reduce neonatal mortality and morbidity. The difference in birthweight between study group and control group may be an effect of the therapy or may be caused by selection bias. The perinatal outcome in the study group suggests that there may be a subgroup of patients who might benefit from hemodynamic treatment.
评估重度子痫前期血流动力学临时处理的母婴及围产期结局。
研究组为57例孕周35周及以下的子痫前期妇女，在有创血流动力学监测下接受扩容和血管扩张治疗，回顾性地与另一中心未进行扩容和有创监测治疗的对照组进行匹配。
两组妊娠均延长了10 - 11天。两组的孕产妇发病率均较低。未观察到血流动力学监测的并发症。研究组（7.1%）和对照组（14.3%）的围产儿死亡率无显著差异。研究组小于胎龄儿的发生率（9%）显著低于对照组（33%）。
对早期重度子痫前期患者进行临时治疗，无论是否进行扩容和有创血流动力学监测，均可降低新生儿死亡率和发病率。研究组与对照组出生体重的差异可能是治疗的效果，也可能是选择偏倚所致。研究组的围产期结局提示可能有一部分患者会从血流动力学治疗中获益。
