胎盘早剥早期诊断误诊原因分析(附17例分析)

Causes of Misdiagnosis in Early Stage Placental Abruption (analysis of 17 cases)

目的探讨不典型胎盘早剥产前误诊的原因分析,以提高对胎盘早剥的警惕性及早期诊断处理。方法对我院2003年3月至2006年3月收治的17例胎盘早剥病例进行回顾性分析。结果临床表现,以阴道出血伴腹痛12例(70.59%),血性羊水1例;以头晕为首发症状1例,后继发腹痛及阴道出血;5例(29.4%)无症状,产后检查胎盘发现;主要体征为子宫收缩,子宫敏感,易激惹。妊娠合并妊娠期高血压疾病为诱因8例(47.1%),产前B超诊断3例(17.61%),产前临床诊断5例(29.41%)。结论胎盘早剥是妊娠晚期一种严重的并发症,严重威胁孕产妇及胎儿的生命,其预后的关键是早期诊断和及时的治疗,胎盘早剥临床表现多样化,同时也缺乏特异的检测手段,早期容易造成误诊及漏诊。应提高对胎盘早剥的警惕性,结合诱因、临床表现、细致的检查,提高超声检查的诊断水平,尽早对其作出正确诊断及处理。

Objective To discuss the causes of misdiagnosing of placental abruption without typical syndromes, to increase cautiousness to placental abruption as to lead proper early diagnosis and treatment. Methods Seventeen eases of placental Abruption from March 2003 to the March 2006 were reviewed retrospeetively. Results Clinical manifestations： vaginal bleeding and abdominal pain; 12eases （70.59%）. bloody amino fluid：l eases; main sign is uterine contraction, irritable uterine. Main factor is preeelapeia：8 eases （47.1%）. preparum diagnosis with ultrasound：3 eases （17.61%）. prepartum diagnose： 5 eases （29.41%）. Conclusions Placental Abruption is a severe complieation in late pregnaney and may threaten maternal and fetal lies, Early diagnosis and treatment is the key to improve prognosis. We need inerease cautiousness to placental Abruption, to improve the ultrasound diagnose rate, by united analyzing the eauses, dinie syndromes and eareful examination to make early correet diagnosis and treatment.