Clinic Analysis Of 123 Cases Of Hypertensive Disorder Complicating Pregnancy

High risk pregnancy is a focal point all the time as to obstetric workers. It is a disadvantage factor that threatens fetus'and parturients'healthy and life. hypertensive disorder complicating pregnancy which is the second reason of parturients'death is one of high risk pregnancy, the mortality is 12% of parturient s'death. it is also the major cause of fetus bad prognosis and death at abroad, the morbidity of hypertensive disorder complicating pregnancy is 6%-8%, and is 9.4% in our country. The morbidity difference conpanied with the difference of economy and climate in every region. In the recent years, following the development investigation of etiology and pathogenesy and early prediction and early diagnosis and early therapy and precaution of hypertensive disorder complicating pregnancy, Strengthening perinatal period prenatal diagnosis and health education, controlling pathogenetic condition efficiently, the mortality of fetus and parturient is drawdown gradually. While the descendance still presences region differences. Scholars in and out of our country worked hard and discovered that the pathogenetic condition serious degrees of hypertensive disorder complicating pregnancy correlated closely with prognosis of mothers and infants. Actively controlling progression of disease, decreasing complications'happen, the key point was to cut down perinatal and parturient mortality rate, improve pregnancy outcome. Because that we have notclearly recognited the etiological factor and pathogenesy of hypertensive disorder complicating pregnancy, in clinic the therapeutic principle is mainly symptommatic treatment and termination of pregnancy at the right moment. But with regard to part cases of hypertensive disorder complicating pregnancy, particularly cases of serious pathogenetic condition and various complication, the therapeutic efficacy is not well and the threaten of the lives and healties of perinatal infants and parturients is big. This article retrospectively studied and analyze 123 cases of clinic datus of hypertensive disorder complicating pregnancy and studied different grade s'incidence and influence with perinatal infant and parturient. The article also studied the complication s'happening and the influence about perinatal fetus, extended gestational weeks whether or not can improve prognosis, studied difference factor between city and countryside at the morbility of hypertensive disorder complicating pregnancy. It had important significance to elevate living quality and improve prognosis and work well health protection between city and countryside.Methods:Retrospectively analyzed 123 cases of hypertensive disorder complicating pregnancy at the third clinic medical college of jilin university in 1999.1～2007.3. the ages were between 19 and 41, the average age was 28.5 years. primipara was 72cases,and multipara was 51 cases. Morbility gestational weeks is 22～41+6 weeks. Among the total, little than 28 weeks were 5 cases; 28～32+6 weeks were 10 cases; 33～36+6 weeks were 28 cases; 37～41+6 weeks were 80 cases. single birth is 112 cases, bigeminal birth were 9 cases, triplets were 2 cases. The blood pressure was between 135～220 and 90～130 mmHg. hyperproteinuria was between (+)and (++++) .hydroncus was between (+)and (++++). 48 cases had complications, and 75 cases had not complications. In complication group, there were 4 cases of placental abruption, 5 cases of gestational hypertensive heart disease,5 cases of HELLP symptom, 38 cases of gestational hypertensive retinopathy, 3 cases of seroperitoneum,4 cases of acute renal failure, 4 cases of postpartum hemorrhage. There were no patients dead in 123 cases. The fetus were 136 cases, containing 9 cases of twin pregnancy, 2 cases of triplet pregnancy; newborn infants were 119 cases, fetus dead were 17 cases. The research study that how was the morbility proportion about hypertensive disorder complicating pregnancy and complications, and the influence of complication and termination time of pregnancy to infant and fetus ,also studied the differences between city and countryside. All above mentioned datus were statisticed by SSPS11.5, adopting t test andχ2test, P < 0.05 had statistical significance.Results:1 in the 123 cases of hypertensive disorder complicating pregnancy, mild pre-eclampsia were 48 cases, morbility proportion was 39.03%; sever per-eclampsia were 58 cases, morbility proportion was 47.15%; eclampsia were17 cases, morbility proportion was 13.82%. the morbility proportion of cases which have severe pathogenetic condition was large.2 the morbilities of complications of hypertensive disorder complicating pregnancy was: gestational hypertensive Retinopathy (30.89%), Gestational hypertensive heart disease(4.07%),HELLP syndrome(4.07%), acute renal failure(3.25%), seroperitoneum(2.44%), placental abruption(3.25%), postpartum hemorrhage(3.25%). The morbility proportion of complication from high to low was: gestational hypertensive retinopathy (60.32%) hypertensive heart disease(7.94%), HELLP syndrome(7.94%), placental abruption(6.35%),acute 35%), seroperitoneum(4.76%).There was statistical significance between complication group and non-complication group, as to above-mentioned complications, besides postpartum hemorrhage.3 the complication group(48 cases ) had 50 cases fetus , and 35 cases of those happened immature labor, FGR, low birth weight infant, neonatal asphyxia, fetal distress, death. While the non-complication group (75 cases) had 86 cases fetus, and 31 cases happened above influences. There was statistical significance between the two groups. The morbility of immature labor and FGR and low birth weight infant and fetal distress and death in complication group was higher than that in non-complication group. There was statistical significance between the two groups. The same condition also happened with fetus weights and gestational age. Inadequacy 28 weeks were 5 cases. Exceedand equal 28 weeks, inadequacy 37 weeks were 41 cases. Exceed and equal 37weeks and inadequacy 42 weeks were 90 cases. As to the morbility of immature labor and FGR and low birth weight infant and fetal distress and death, there wss statistical significance between group of inadequacy 37 weeks and group of exceed and equal 37 weeks. the asphyxia neoatorum had not statistical significance.4 In 123 cases of hypertensive disorder complicating pregnancy, there was difference between patients living in Countryside and city. as to different degree patients of hypertensive disorder complicating pregnancy , mild pre-eclampsia patients who lived in countryside were 19 cases, in city were 29 cases, sever pre-eclampsia patients who lived in countryside were 35 cases, in city were 23 cases, eclampsia patients who lived in counhyside were 15 cases, in city were 2 cases, comparing three groups, P<0.05. Conclusion:1 as to the morbility proportion of hypertensive disorder complicating pregnancy in our hospital, sever pre-eclampsia and eclampsia were high(60.97%).2 the morbilities of complications of hypertensive disorder Complicating pregnancy from high to low were: gestational hypertensive retinopathy (30.89%), gestational hypertensive heart disease (4.07%), HELLP syndrome (4. 07%), acute renal failure (3.25%), seroperitoneum (2.44%), placentalabruption(3.25%), postpartum hemorrhage(3.25%). The complication's happening was related closely with pathogenetic condition.the key point of controlling pathogenetic condition and reducing complication's happening was early discovery and early treatment. It improved prognosis at the last.3 the pathogenetic condition and complication of hypertensive disorder complicating pregnancy was related closely with fetus's prognosis. It was a important way to reduce the morbility of complication of hypertensive disorder complicating pregnancy.4 there was statistical significance of hamful effects between term infant and non-term infant. So reasonably extending gestational age was a important way which could improve prognosis.5 there was difference of morbility of hypertensive disorder complicating pregnancy between city and countryside. the morbility proportion of sever pre-eclampsia and eclampsia in countryside was higher than that in city. There was important significance to strengthen circumnatal period health protection and the three grades of maternal and child health care network, especially in countryside. It could also reduce the morbility of hypertensive disorder complicating pregnancy and harmful effects.