| Objective:Research preeclampsia women 24 hours ambulatory blood pressure change,heart guardianship,umbilical cord blood S/D ratio,flow resistance record perinatal outcome,rhythmicity of blood pressure during pregnancy,and the effects on maternal and infant outcomes.Methods:The clinical data of pre-eclampsia patients who were delivered in our hospital from January 2016 to June 2017 were prospectively analyzed,from early 60 example,chronic and 60 cases of severe preeclampsia,at the same time without pregnancy complication of hospital similar age of 60 cases of pregnant women as control group.All three groups of pregnant women were subjected to 24-hour dynamic blood pressure monitoring,fetal heart monitoring,and the measurement of the S/D ratio of umbilical artery in obstetrics and gynecology.Neonatal Apgar scores,gestational weeks,birth weight and neonatal ICU were recorded after delivery and were followed up to seven days after birth.To understand the complications of neonates.The changes of 24-hour dynamic blood pressure in the three groups were analyzed,the changes of the fetal heart monitoring results,the changes of the umbilical cord blood flow resistance S/D,and the outcome of the newborn.Results:1 The basic comparison of the three groups of pregnant women.The basic situation of the three groups of pregnant women showed that there was no statistically significant difference in age difference between the preeclampsia group,the severe pre-eclampsia group and the control group in the control group(P>0.05).There was no statistically significant difference between the three groups in pre-eclampsia group,severe pre-eclampsia group and control group(P>0.05).2 Changes of dynamic blood pressure in three groups of pregnant women.2.1 Comparison of dynamic blood pressure in three groups of pregnant women.In the control group,24 hours of dynamic blood pressure was observed,and the arytenoid of"double peak and one valley"was changed.In the pre-eclampsia group,24-hour dynamic blood pressure was still in the"double peak and one valley",but the blood pressure was higher than the normal range.In severe pre-eclampsia group,24-hour dynamic blood pressure of pregnant women lost normal rhythm,and nocturnal blood pressure was not significantly decreased,and it was non-arytenoid,with a higher blood pressure value and a more pronounced increase in diastolic blood pressure.2.2 Comparison of the mean blood pressure of the three groups.DSBP,dDBP,nSBP,nDBP,24hSBP and 24hDBP were all higher than the normal control group in severe pre-eclampsia group and pre-eclampsia group.The difference was statistically significant(P<0.05).Severe preeclampsia group and preeclampsia group nighttime systolic blood pressure drop ratio,nocturnal diastolic blood pressure drop ratio were lower than the control group,difference have statistical significance(P<0.05),and severe preeclampsia group than in preeclampsia group is more significant difference in decline rate(P<0.05).3 Comparison of three groups of fetal heart monitoring.Cardiac monitoring NST assessment results show that the control group,patients with preeclampsia(preeclampsia group and severe preeclampsia group)in the three groups in cardiac care NST evaluation diff were statistically significant(P<0.05).4 Comparison of blood flow PI,RI and S/D of the umbilical cord of the three groups before delivery.In the 24 hours before the birth of the newborn,the umbilical cord blood flow index showed that the three groups had statistically significant differences in PI,RI and S/D ratio(P<0.05).5 Adverse outcomes of perinatal infantsAderse outcome after childbirth poor neonatal outcomes show that a total of severe preeclampsia is higher than the preeclampsia group and the control group,difference have statistical significance(χ~2=18.355,P<0.05);The pulmonary hyaline membrane disease,ischemic anoxic encephalopathy incidence of severe preeclampsia group higher than that of preeclampsia and the control group,difference has statistical significance(P<0.05);And the incidence of neonatal asphyxia,perinatal death three groups has no statistical significance(P>0.05).6 Three sets of anomalies and the result of the preemiesThe results showed that there were statistically significant differences between the three groups(P<0.05),and the preeclampsia was higher than that of pre-eclampsia and the control group.7 The comparison of the value of the adverse outcomes of the perinatal infants with single detection methods and combined detection methods.Various detection methods showed that the predictive value of combined detection for the prognosis of adverse perinatal infants was significantly higher than that of blood pressure rhythm abnormality,fetal heart monitoring abnormality and umbilical cord blood flow S/D.The prognosis of preterm infants was predicted by joint test,and their sensitivity,specificity,positive predictive value and negative predictive value were 92.33%,90.65%,64.56%and 98.04%,respectively,higher than the single index prediction parameters.Conclusions:1.The 24-hour ABPM blood pressure increased with the aggravation of pre-eclampsia and gradually lost normal circadian rhythm.2.The decrease rate of nocturnal diastolic blood pressure plays a certain role in predicting adverse pregnancy outcomes in patients with pre-eclampsia.3.Changes in the S/D ratio of various indicators of dynamic blood pressure,fetal heart monitoring and umbilical blood flow resistance were all related to adverse pregnancy outcomes,and the combined diagnosis was of greater value. |
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