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임신 34주 이전에 발병한 중증 자간전증의 임상적 고찰

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Affiliated Author(s)
김종인
Alternative Author(s)
Kim, Jong In
Journal Title
대한산부인과학회잡지
ISSN
0494-4755
Issued Date
1998
Abstract
Preeclampsia mainly develops in late pregnancies. Preeclampsia remote from term is different from preeclampsia at near term in that preeclampsia remote from term is more often associated with high maternal and perinatal mortality and morbidity, and the expectant management is more advocated than the aggressive management in severe preeclampsia remote from term. In order to study the clinical characteristics of severe preeclampsia remote from term, 56 cases with severe preeclampsia developing before 34 weeks gestation who were admitted to Department of Obstetrics and Gynecology, Keimyung University from January, 1991 to December, 1996 was retrospectively analyzed. The results were as follows: 1. Mean maternal age, mean gestational age at onset, mean gestational age at delivery, and the prolongation of gestation were 30±5 years, 31.1±3.5 weeks, 32.8±3.2 weeks, and median 9.8 days (0∼48 days), respectively. 2. The preeclampsia was most common in the aged group ranged from 25 to 29 years and from 30 to 34 years and its incidence in the aged group was 35.7% and 35.7%. 3. The most prevalent gestational period at onset was 30∼34 weeks gestation, and its incidence was 76.8%. the most prevalent gestational period at delivery was 30∼34 weeks gestation, and its incidence was 57.1%. 4. In the indication for the classification of severity, persistent proteinuria ≥2+, diastolic B.P≥110 mmHg, and fetal growth retardation were most common, it`s incidence was 91.1%, 41.1%, and 39.3%, respectively. 5. 8.9% of patients had chronic hypertension as an underlying disease. 6. Indication for delivery in the expectant management were fetal distress (26.8%), uncontrolled HBP (26.8%), FDIU (16.0%), PROM (8.9%) premature labor (7.1%), oligohydramnios (5.4%), placenta abruptio (3.6%), headache (1.8%), pulmonary edema (1.8%), etc. 7. Idiopathic respiration distress syndrome ocurred in 46.4%. 8. Mean birth weight was 1,628±365 gm. The birth weight ranged from 1500 to 1999 gm was most common, and its incidence was 47.5%. 9. Of 56 patients who received antihypertensive drugs, 21.4% of patients had good responses (respond to one drug), 25.0% of patients had moderate responses (respond to two drugs), 53.6% of patients had poor responses (refractive to two drugs). 10. In the mode of delivery, vaginal delivery and cesarean birth were performed in 41.1%, and 58.9% of patients, respectively.
1991년 1월 1일부터 1996년 12월 31일까지의 계명대학교 의과대학 부속병원에 입원했던 자간전증 환자 중에서 임신 34주 이전에 발병한 중증 자간전증 환자 56명을 역학적으로 분석하였다. 결과는 다음과 같다. 1. 평균 나이는 30±5세, 평균 발병 주수는 31.1±3.5 주, 평균 분만 주수는 32.8±3.2주, 임신 연장 기간은 중 위수로 9.8일(범위 0∼48일)이었다. 2. 연령별 발생 빈도는 26∼29세군과 30∼34세군이 35.7%, 35.7%로 많았다. 3. 발병 주수는 30∼34주가 76.8%로 가장 많았고 분 만 주수는 30∼34주가 57.1%로 가장 많았다. 4. 중증 자간전증의 분류 기준 항목으로는, 2도 이상 의 지속적인 단백뇨(91.1%), 확장기 혈압이 110 mmHg 이상(58.9%), 태아발육지연(39.3%)이었다. 5. 지병으로 만성 고혈압증이 있었던 환자는 8.9%였다. 6. 보존적 치료 중 분만 적응증은 태아곤란증이 26.8%, 약제에 반응하지 않는 고혈압이 26.8%로 많았고 자궁내 태아 사망 16.0%, 조기 양막 파수 8.9%, 조기 진통 7.1%, 양수과소증 5.4%, 두통 1.8%, 폐부종 1.8% 등이었다. 7. 쌍태아를 포함한 전체 59명의 신생아 중에서 임신 30에서 34주 사이에 분만된 신생아 35명(쌍태아 3명 포함) 호홉곤란증은 23명(41.1%)이었고 임신 35주 이상에서 분 만된 15명의 신생아 중 호홉곤란증은 3명(5.3%)이었다. 8. 평균 신생아 체중은 1.628±365 gm이었고 1500∼ 1999 gm군이 47.5%로 가장 많았다. 9. 혈압 하강제를 투여한 56명 중에서 양호한 반응(한 약제에 반응)예는 21.4%, 중등도 반응(두 약제에 반응)예 는 25.0%, 불량(두 약제에도 반응 보이지 않음) 예는 53.6% 이었다. 10. 분만 방식에 있어서 질식 분만은 41.1%, 제왕절개 술은 58.9%이었다.
Alternative Title
The Clinical Evaluation of Severe Preeclampsia Developing before 34 Weeks Gestation
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Publisher
School of Medicine
Citation
하연옥 et al. (1998). 임신 34주 이전에 발병한 중증 자간전증의 임상적 고찰. 대한산부인과학회잡지, 41(9), 2318–2322.
Type
Article
ISSN
0494-4755
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/39058
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
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