A Comparative Study On Early 0nset And Late Onset Severe Preeclam Psia

Objective To analyze the characteristics of early and late onset severe preeclampsia involving maternal major complication, the method of pregnancy termination and perinatal outcomes; To evaluate perinatal outcomes of expectant management of early onset severe preeclampsia.Methods two hundred and thirty nine cases meeting the criteria of severe preeclampsia were enrolled in this study, By logistic analyse method in The second clinical hospital of shan xi medical university in December 2009 to January 2011. According to their onset gestation ages patiens were divided in two groups: Early onset severe preeclamPsia were group A (n=115)with those onset≤34weeks of gestation and late onset severe preeclamPsia were group B(n=124) with onset >34 weeks of gestation. early onset group were divided into two groups by accepting conservative management or not as group A1(n=56)that sufferer,s condition is steady and group A2(n=59)to compare the maternal major complications and perinatal outcomes.Results there were bigger contractive pressure and diastolic pressure in early onset group than in late onset group who had standard antenatal care (P>0.05).there were earlier in early onset group than in late onset group about terminated gestation ages(P<0.05).there were significant differences between group A and group B in the incidence rate of placental HELLP syndrome flooding Hypoproteinemia hepatic dysfunction eyeground disorder (P<0.05). there were no significant different in the incidence of complications between group A1 and group A2(P>0.05). Caesarean section was a main method of Pregnancy termination to choose for all groups. there were bigger Caesarean section rate in early onset group than in late onset group(P>0.05).And the incidence of Suffocation, fetal distress,dead fetus in uterus, neonatal deformations were also different between group A and group B, .And the incidence of Suffocation in early onset group higher than in late onset group(P<0.05). In group A1 Cesarean section rate of fetal growth restriction, fetal distress , Suffocation lower than group A2 In early onset group, but there were no significant different in the incidence of complications between group A1 and group A2(P>0.05).Conclusion Early onset severe preeclampsia is easy to have many kinds of complications, affect maternity and perinatals seriously·Expectant management is feasible and effective in early onset severe Preeclampsia, in the balance of maternal-fetal condition,expectant management can Prolong gestation age and get better Prenatal Prognosis. .During the expectant management, the situation of maternity and Perinatals should be closely monitored, and cesarean section in the first choice. Caesarean section rate in early onset group than in late onset group.