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早发型子痫前期尚无统一的临床时间界定,目前多以孕34周界定早发型重度子痫前期,其特点为围生儿死亡率高及母体的并发症出现早且严重。发生于孕24周以前的重度子痫前期患者应终止妊娠;对于孕24~28周患者,应根据具体情况考虑;对于孕28~34周患者,应在严密的母婴监护确保母婴安全的前提下行期待疗法。近年来抗凝治疗因能改善母婴结局而成为研究热点,其中低分子肝素不良反应少,作用时间长,用药方便,对胎儿安全,可以应用于临床。文章就早发型重度子痫前期治疗方案的选择原则作一综述。
Early onset of preeclampsia there is no uniform clinical definition of the time, most of the current 34 weeks to define early onset severe preeclampsia, characterized by high perinatal mortality and maternal complications appear early and severe. Patients with severe preeclampsia occurring before 24 weeks of gestation should terminate their pregnancy; patients with gestational age from 24 to 28 weeks should be considered on a case-by-case basis; and maternal and child maternity care should be ensured in strict maternal and child care settings for patients 28-34 weeks pregnant The premise down the line expectant therapy. In recent years, anticoagulant therapy can improve the maternal and infant outcomes and become a research hot spot, in which low molecular weight heparin adverse reactions, the role of a long time, medication convenient, safe for the fetus, can be applied to the clinic. The article reviews the principle of selection of early-onset severe preeclampsia.