Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care.
Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care.
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DOI：
10.1177/1753944715597622
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发表时间：
2015-08-01
影响因子：
2.3
通讯作者：
Novo, Joe Luiz Vieira Garcia
中科院分区：
文献类型：
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作者：
Barbosa, Isabela Roberta Cruz;Silva, Wesley Bruno Merencio;Novo, Joe Luiz Vieira Garcia
背景技术背景：妊娠期高血压疾病（HDP）是拉丁美洲和加勒比海地区孕产妇和胎儿死亡及妊娠并发症的最重要原因。结论：本研究的目的是描述巴西三级参考医院收治的HDP妇女的流行病学特征，并评估每个HDP的孕产妇和胎儿结局以及产前护理对孕产妇和胎儿结局的影响。1501例女性HDP根据通常定义分为慢性高血压（n = 564），先兆子痫（n = 579），子痫（n = 74）和先兆子痫/子痫叠加慢性高血压（n = 284）。将不良孕产妇和胎儿结局记录为孕产妇死亡和未遂，将胎儿结局记录为死产、新生儿死亡和新生儿呼吸系统并发症。产前护理分为完整（106次访问），不完整（<6次访问）或没有done.RESULTS：子痫的妇女是年轻的（15岁），68%是在他们的第一次怀孕，有较高的血压，较高的死亡率和更多的近错过的情况下，他们的孩子出生体重较低，子宫内和新生儿死亡率较高，呼吸窘迫。先兆子痫/子痫叠加慢性高血压的妇女及其胎儿的结局居中，而慢性高血压和先兆子痫的妇女在HDP患者中结局较好。有不完整的产前护理或产前没有做的妇女有逐渐升高的死亡率和更大的频率近错过的情况下，他们的孩子有较高的死亡率。结论：在三级参考医院，子痫和慢性高血压叠加先兆子痫与最坏的结果为母亲和胎儿，而完整的产前护理与更好的母亲和胎儿的结果在HDP。
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are the most important cause of maternal and fetal death and pregnancy complications in Latin America and the Caribbean.OBJECTIVES: The objective of this study was to characterize the epidemiological profile of women with HDP admitted to a Brazilian tertiary reference hospital, and to evaluate maternal and fetal outcome in each HDP and the impact of prenatal care on the maternal and fetal outcome.METHODS: HDP in 1501 women were classified according to usual definitions as chronic hypertension (n = 564), pre-eclampsia (n = 579), eclampsia (n = 74) and pre-eclampsia/eclampsia superimposed on chronic hypertension (n = 284). Adverse maternal and fetal outcomes registered as maternal death and near miss and fetal outcomes documented as stillbirth, neonatal death and newborn respiratory complications were compiled. Prenatal care was classified as complete (⩾ 6 visits), incomplete (< 6 visits) or not done.RESULTS: Women with eclampsia were younger (15 years), 68% were on their first pregnancy, had higher blood pressure, higher mortality and greater number of near miss cases and their children had lower birth weight, higher intra-uterus and neonatal mortality, and more respiratory distress. Women with pre-eclampsia/eclampsia superimposed on chronic hypertension and their fetuses had intermediate outcome and those with chronic hypertension and pre-eclampsia the better outcome among those with HDP. Women who had incomplete prenatal care or prenatal not done had progressive higher mortality rates and greater frequency of near miss cases, and their children had higher mortality rates.CONCLUSION: In a tertiary reference hospital, eclampsia and chronic hypertension superimposed on pre-eclampsia are associated with a worst outcome for mothers and fetuses, whereas complete prenatal care is associated with a better maternal and fetal outcome in HDP.