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Journal of the Korean Academy of Family Medicine 1994;15(6):333-343.
Published online June 1, 1994.
A Clinical Study on Preeclamptic Patients.
Seong Mi Choi, Hyang Keun Seo,
자간전증 환자에 관한 임상적 고찰
최성미, 서향근, 민보은
Abstract
Background
: Preeclampsia is a mian cause of maternal death and as it involves multiple organs, there is a wide variation in clinical symptoms and outcomes. In addition, ti leads to both high maternal and perinatal morbidity and mortality. So, this study was carried out to evaluate general clinical characteristics of preeclamptic patients.

Methods : 214 cases of preeclamptic patients among 10,331 pregnant women admitted in the department of obstetrics & gynecology, Ilsin Christian Hospital in a period of one year from January 1992 to December 1992 were analysed. The differences of the laboratory data between mild and severe preeclamptic patients were taken statistics by using SPSS. Also perinatal mortality rates were obtained according to gestational age, birth weight, and so on.

Results : The incidence of preeclampsia was 3.2% of all deliveries, among this study group, mild was 30.8% and severe was 69.2%. According to age and parity distribution, 55.6% were age group 25-29 and 64.5% were primiparity. The incidence of low birth weight(<2500gm) infant was 30.1%. Normal vaginal deliveries were 70.6%, vacuum deliveries were 3.7%, cesarean section were 25.7%. No significant difference between mild and severe preeclampsia was found in values of hemoglobin, hematocrit, platelet count, fibrinogen. Serum total protein of mild preeclampsia was 6.07gm/dl, that of severe preeclampsia was 5.74gm/dl, there was significant difference between mild and severe preeclampsia(P<0.01). Serum albumin of mild preeclampsia was 3.19gm/dl, that of severe was 2.97gm/dl, there was significant difference between mild and severe preeclampsia(P<0.01). There was no significant difference between mild and severe preeclampsia in values of serum SGOT, SGPT and alkaline phosphatase. The value of BUN in mild preeclampsia was 9.59mg/dl, that of severe was 10.86mg/dl, there was significant difference between mild and severe preeclampsia(P<0.01). The value of seum creatinine in mild preeclampsia was 0.75gm/dl, that of severe was 0.77mg/dl, there was no significant difference between mild and severe preeclampsia. The value of serum uric acid in mild preeclampsia was 5.66mg/dl, that of severe was 6.17mg/dl, there was significant difference between mild and severe preeclampsia(P<0.05). Perinatal mortality rate of primiparity was 61.2, that of multiparity was 101.3. Perinatal mortality rate was prominently high the group of gestatioinal week less than 29. Perinatal mortality rate related to birth weight was prominently high in the group of less than 1500 gm.

Conclusion : Significant differences between mild and severe preeclampsia were found in the values of serum total protein, serum albumin, BUN and serum uric acid. Perinatal mortality rate was prominently high in the gruop of gestational week less than 29 and in the group of birth weight less than 1500gm.
초록
연구배경 : 자간전증은 모성 사망의 주요 원인들 중의 하나이며, 여러 장기를 침범함으로써 다양한 임상 증상과 결과를 보이고, 모체 및 태아에 높은 이환율 및 사망률을 초래한다. 이에 본 연구에서는 자간전증 환자에 대한 제반 임상적 상황을 알아보고자 하였다.

방법 : 1992년 1월부터 1992년 12월까지 1년간 일신기독병원에서 분만하였던 총 10,331예 중 모든 혈액화학 검사를 받은 자간전증 환자 214명의 의무기록을 조사하고 경증 및 중증 자간전증 환자의 검사소견 차이를 통계처리하였으며, 또한 임신 주수, 출생시 체중등에 따른 주산기 사망율을 구하였다.

결과 : 총 분만수에 대한 자간전증의 발생율은 약 3.2%였으며, 경증의 자간전증이 30.8%, 중증의 자간전증은 69.2%였다. 연령별 분포는 25-29세 군이 55.6%로 가장 많았고, 64.5%가 초산부였다. 자간전증 환자의 분만시 신생아 체중은 2500gm 이하의 저출생 체중아가 30.1%였다. 자간전증 환자의 70.6%는 자연분만하였고, 기계분만이 3.7%, 제왕절개술이 25.7%였다. 혈색소치, 적혈구 용적, 혈소판치, 섬유소원치는 모두 경중 자간전증 환자와 중증 자간전증 환자 사이에 유의한 차이가 없었다. 혈청 총단백질양은 경증 자간전증 환자는 6.07 gm/dl, 중증 자간전증 환자는 5.74 gm/dl로서 경증과 중증 자간전증 환자 사이에 유의한 차이가 있었고(P<0.01), 혈청 알부민치는 경증 자간전증 환자에서는 3.19 gm/dl, 중증 자간전증 환자에서는 2.97 gm/dl로서 역시 유의한 차이를 보였다(P<0.01). 혈청 SGOT, SGPT 및 alkalin ephosphatase(이하 ALP로 약함)치는 경증 자간전증 환자와 중증 자간전증 환자사이에 유의한 차이는 없었다. BUN치는 경증 자간전증 환자에서는 9.59mg/dl, 중증 자간전증 환자에서는 10.86 mg/dl로서 유의한 차이가 있었고(P<0.01), 혈청 크레아티닌치는 경증에서는 0.75mg/dl, 중증에서는 0.77 mg/dl로서 유의한 차이가 없었다. 혈청 요산치는 경증에서 5.66mg/dl, 중증에서 6.17mg/dl로서 유의한 차이가 있었다(P<0.05). 초산부에서 주산기 사망율은 61.2였고, 경산부에서는 101.3이었다. 임신 주수에 따른 주산기 사망율은 29주 미만군에서 현저히 높았다. 1500 gm미만의 극소저출생아에서 주산기 사망율이 현저히 높았다.

결론 : 혈청 총단백질양, 혈청 알부민치, BUN치 및 혈청 요산치는 경증 자간전증 환자와 중증 자간전증 환자 사이에 유의한 차이가 있었으며, 주산기 사망율은 임신 주수 29주 미만군과 출생시 체중 1500gm 미만군에서 현저히 높은 경향을 보여주었다.


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