Clinical Analysis Of Prediction And Intervention For Hypertensive Disorder Complicating Pregnancy And Pregnancy Outcomes

Objective: To explore the methods of prediction and intervention for hypertensive disorders complicating pregnancy,to find some effective prediction and intervention methods of reducing the incidence of hypertensive disorder complicating pregnancy,delaying disease severity and improving the pregnancy outcomes.Methods: Retrospectively analyze the pregnant women who delivered in Jiujiang Maternal and Child Health Care Hospital from January 2015 to June 2016,excluding pregnant patients with chronic hypertension,diabetes,chronic kidney diseases,a total of 13807 cases.Divide these cases into two groups according to the prediction and intervention of pregnancy.Those who had regular antenatal care in Jiujiang Maternal and Child Health Care Hospital,and implemented prediction and intervention are classified into the case group,with a total of 9218 cases.Those who have not regular antenatal care in the hospital,did not implement the prediction and intervention are put into the control group,with a total of 4589 cases.Prediction methods include predicting the possibility of disease through high risk factors,monitoring system testing of hypertensive disorder complicating pregnancy(abbreviation MP monitoring system),predicting disease severity through fundus examination.Intervention methods include life intervention--pregnancy nutrition guidance,exercise regulation,weight management;drug intervention--calcium supplement,folic acid and vitamin B12 personal supplement,aspirin anticoagulant therapy on pregnant women with severe preeclampsia history;at the same time,given psychological intervention and health education.Finally,make a statistical analysis of the results of MP monitoring system,human MTHFR and MTRR gene detection,the incidence of hypertensive disorder complicating pregnancy,maternal complications and perinatal outcomes.Results:(1)The true positive rate(sensitivity)of MP monitoring system for hypertensive disorder complicating pregnancy is 84.03%,the true negative rate(specificity)is 97.13%.(2)Folic acid metabolic disorders genetic test shows37.71% cases are not in the risk,and the risk rate is 62.29%.(3)The incidence of hypertensive disorder complicating pregnancy case group is 2.85%,while the control group's is 9.70%,the difference is statistically significant(P<0.05).(4)The case group maternal complications: placental abruption,placenta stroke,postpartum hemorrhage,retinopathy,hypertensive heart disease and hypoproteinemia are lower than those in the control group,the difference is statistically significant(P<0.05).(5)The case group perinatal complications: incidence rate of less than gestational age,fetal distress,premature birth and fetal death is lower than that of the control group(P<0.05).Conclusion:(1)The MP monitoring system can be used for the prediction of hypertension disorder complicating pregnancy in pregnant women.Early prediction and intervention is advisable.(2)Folic acid metabolic disorders genetic test suggests that the majority of pregnant women are at risk,pregnant women should be well prepared from pre-pregnancy and have the folic acid metabolic disorders genetic test as early as possible,and personalize supplement folic acid and vitamin B12 according to the outcome.(3)The prediction of hypertensive disorder complicating pregnancy should be divided into different levels,which is not only to predict the occurrence of disease,but also to predict the severity of the disease.(4)Prediction and intervention for pregnant women with hypertensive disorder complicating pregnancy can effectively reduce the incidence of hypertensive disorder complicating pregnancy,alleviate disease severity,lower the incidence of maternal complications and improve maternal and neonatal outcomes.