摘要
目的:探讨预防性应用低分子肝素对早发型子痫前期患者再次妊娠结局的影响。方法:选择2010年1月至2015年12月期间,因早发型子痫前期在郑州大学第一附属医院终止妊娠,再次妊娠后在本院定期产检并终止妊娠的患者共99例为研究对象。分为A组:预防性应用低分子肝素57例,B组:未应用低分子肝素42例,两组均为单胎妊娠,比较两组再次妊娠结局。结果:A组延长妊娠时间、新生儿存活率、新生儿出生体质量均多于B组,A组新生儿窒息、胎儿生长受限、早发型子痫前期、子痫前期、严重并发症的发生率均小于B组,差异均有统计学意义(P<0.05);A组纤维蛋白原(FIB)、D-二聚体(D-D)水平低于B组,差异有统计学意义(P<0.05)。A组本次分娩孕周、新生儿出生体质量、新生儿存活率均大于前次妊娠,严重并发症、胎儿生长受限、新生儿窒息的发生率均小于前次妊娠,差异有统计学意义(P<0.05);B组本次分娩孕周、新生儿出生体质量均大于前次妊娠,差异有统计学意义(P<0.05);B组两次妊娠严重并发症、新生儿存活、胎儿生长受限、新生儿窒息的发生率比较,差异无统计学意义(P>0.05)。结论:早发型子痫前期患者再次妊娠时预防性应用低分子肝素,可降低子痫前期的复发率及严重并发症的发生率,改善围生儿结局,不增加出血事件的风险。
Objective： To analyze the outcomes of previous early-onset severe preeclampsia patients after pregnancy again treated by low molecular heparin preventively. Methods： Retrospective analysis was performed in 99 cases of pregnant women who terminated previous pregnancy due to early-onset severe preeclampsia dur- ing January 2010 to December 2015 at the first affiliated hospital of Zhengzhou University. 57 cases, regarded as group A,had prophylactically used the low molecular heparin,and the other 42 cases without usage of low molec- ular heparin was regarded as group B. Patients in group A and group B had singleton pregnancy. The pregnancy outcomes in the two groups were compared. Results： Prolonged pregnancy, neonatal survival rate and neonatal birth weight in group A were better than those in group B. The incidence of neonatal asphyxia,fetal growth restriction,early-onset severe preeclampsia, severe preeclampsia, serious complications in group A was lower than those in group B. The above differences were statistically significant （ P 〈 0.05）. The level of FIB and D-D in group A was lower than that of group B. The differences were statistically significant （ P 〈 0.05）. In group A,the pregnancy time, neonatal birth weight and neonatal survival rate were better than those in previous pregnancy. The incidence of neonatal asphyxia,fetal growth restriction and serious complications was lower than that of the previous pregnancy. These differences were statistically significant （ P 〈 0.05）. In group B, the pregnancy time and neonatal birth weight were better than those in previous pregnancy. The differences were statistically signifi- cant（ P 〈 O. 05）. There was no statistically significant difference between two pregnancies when comparing the incidence of neonatal asphyxia, fetal growth restriction, neonatal survival rate and serious complications （P 〉 0. 05）. Conclusions ： Prophylactical usage of low molecular heparin in patients with previous early-onset severe preeclampsia during pregnancy again could reduce the recurrence rate and the incidence of serious complications of preeclampsia,improve the outcomes of the perinatal period without increasing the risk of bleeding events.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2018年第2期135-139,共5页
Journal of Practical Obstetrics and Gynecology
关键词
早发型子痫前期
低分子肝素
预防性
妊娠结局
Early-onset severe preeclampsia
Low molecular heparin
Preventive
Pregnancy outcomes
