Clinical Analysis Of Early-onset Severe Preeclampsia Complicated With Multiple Organ Dysfunction Syndrome

Objective:To study the clinical characteristics of early-onset severe preeclampsia(EOSP)complicated with multiple organ dysfunction syndrome(MODS),the number and severity of organ involvement and the outcome of pregnancy,and to explore the best timing and way of termination of pregnancy.Methods:A total of 66 patients with early-onset severe preeclampsia combined with MODS were enrolled in this study.The incidence of EOSP was divided into four groups: group A(13 cases)22 to 28 weeks,B group(19 cases)pregnant 28+1 to 30 weeks,C group(10 cases)30+1 to 32 weeks,D group(24 cases)pregnant 32+1 to 34 weeks,all patients are looking forward to treatment MODS appeared during the process.The effects of age,birth rate,gestational age,morbidity of gestational age,termination of gestational age,number of affected organs and severity,and mode of delivery on maternal outcome were analyzed.Results:(1)Among the 66 cases of early-onset severe preeclampsia with MODS,8 cases of postpartum hemorrhage,7 cases of placental abruption,6 cases of DIC,18 cases of HELLP syndrome,6 cases of pulmonary edema,11 cases of eclampsia 38 cases of hypoproteinemia,7 cases of acute heart failure,20 cases of ascites.There was no significant difference in HELL syndrome between the two groups(p<0.05),and the other predisposing factors were not statistically significant.(2)66 cases of 2 patients were injured 29 cases,mortality 0.0%;3 organs damaged in 22 cases,the mortality rate of 4.5%;4 organs were damaged in 10 cases,the mortality rate of 20.0%;5 organs or more damage in 5 cases,The mortality rate was 60.0%.When the number of damaged organs reached more than three,the incidence of patients in group A was much higher than the other three groups.MODS to liver organ damage the earliest,most,followed by kidney,blood clotting,heart,lung,brain.Group A expect the shortest treatment time,the earliest onset,APACHEII score the highest,two pairs of statistical significance.With the increase in the number of organ damage,the patient mortality rate increased.Overall Description: The earlier the onset of the disease,the greater the number of injured organs,the more serious organ damage,the worse the maternal outcome.(3)Four groups of termination of pregnancy compared to A group of rivanol induction rate was significantly higher than C,D two groups.There was significant difference between the four groups in the rate of cesarean section A>B>C>D and p=0.016.(4)perinatal outcome comparison,Apgar score 5 minutes score was statistically significant.FGR,fetal distress,There was no statistically significant difference between the four groups.Comparison of neonatal mortality: four groups Neonatal mortality was significantly different,A group of perinatal mortality was significantly higher than B,C,D three groups(p<0.01).Conclusion:Early onset of severe preeclampsia is an important cause of maternal and perinatal death,easily lead to the occurrence of MODS,and the disease progress rapidly,so early hospitalization is very important to be able to improve the function of various organs in a timely manner,delay the occurrence of complications,The occurrence of MODS.In the event of MODS,must be timely termination of pregnancy,as much as possible to reduce the damage caused by maternal and child.Early onset of severe preeclampsia complicated by the onset of MODS sooner,the more serious the disease,the earlier termination of pregnancy,poor mother and child outcomes.Cesarean section significantly reduced complications of pregnant women and perinatal mortality,but should also be based on the size of gestational age choose the best mode of delivery.Strengthen perinatal mission,to guide regular prenatal care,early detection of severe early signs of preeclampsia,timely blocking the development of MODS is to improve the outcome of perinatal outcome.