임신중독증과 관련된 조산에서 분만주수 및 임신중독증 중증도에 따른 임신부와 신생아의 주산기 예후 비교
Comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia
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목적: 임신중독증과 관련된 조산에서 분만 주수와 임신중독증의 중증도에 따른 임신부와 신생아의 임상적 자료를 분석하여 주산기 예후를 알아보고자 하였다. 방법: 2000년 1월부터 2006년 12월까지 인제대학교 의과대학 일산백병원 산부인과에서 임신중독증으로 진단받은 274예 중 재태연령 37주 미만에 분만한 176예를 대상으로 하였다. 결과: 조산과 관련된 임신중독증에서 임신부의 나이와 분만력에 따라 임신중독증의 발생빈도는 차이가 없었다. 분만적응증은 경증 임신중독증에서는 태아곤란증이, 중증 임신중독증에서는 모체 적응증이 가장 많았으며 중증에서 제왕절개술의 비율이 더 높았다. 모성의 경우에는 임신중독증의 중증도만이, 신생아의 경우는 27주에서 34주 미만으로 태어난 경우에 분만주수와 중증도가 예후와 관련이 있었다. 각 분만 지연 군별로 임신부와 신생아 합병증은 통계학적으로 유의성을 보이지 않았다. 결론: 모성의 경우에는 임신중독증의 중증도만 예후와 관련이 있으며, 신생아의 경우에는 27주에서 34주 미만으로 태어난 경 우에 분만주수와 중증도가 예후와 관련이 있었고 27주 미만과 34주 이후에 태어나는 경우에는 중증도와 분만주수가 예후와 관련이 없었다.
Abstract
Objective: The purpose of this study was to comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia. Methods: Of the 274 cases, we reviewed retrospectively the medical records of 176 preeclampsia mothers and infants delivered before 37 weeks of gestation in the Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital from January 2000 to December 2006. Results: In preeclampsia related to premature birth, it was not different the frequency of maternal age and parity in both mild and severe group. Among indications of delivery, nonreassuring fetal heart rate pattern was most frequent in mild preeclampsia, and maternal condition was in severe preeclampsia. In addition, the rate of cesarean section was higher in severe preeclampsia. Only the severity of preeclampsia was related to prognosis in mothers. On the other hands, gestational weeks on delivery and severity of preeclampsia were related to prognosis in neonates who were born 27+0~33+6 gestatonal weeks. In each group of delayed birth, no statistical significance was observed in maternal and neonatal complications according to birth delay. Conclusions: In case of maternal complications, severity of preeclampsia is related to prognosis. In case of neonatal complications, if the delivery is between 27+0~33+6 gestational weeks, gestational weeks and severity of preeclampsia are importatnt indicators related to the neonate’s prognosis. After 34+0 gestational weeks, severity of preeclampsia and gestational weeks of delivery are not related to the neonate’s prognosis.
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