胎盘早剥经阴道分娩临床分析与监护

Linical Analysis of 87 Cases on Placental Abruption in Vaginal Delivery and Nursing

目的探讨胎盘早剥经阴道分娩指征及处理方法，改善母婴结局。方法回顾性分析我院1993年1月～2006年2月胎盘早剥经阴道分娩87例临床资料。结果发生新生儿轻度窒息5例，重度窒息2例，新生儿死亡12例（均为放弃胎儿），死产2例（均为放弃胎儿）。产妇产后出血12例，没有发生DIC、多脏器功能衰竭，无孕产妇死亡。结论胎盘早剥经阴道分娩，指征不在于结束分娩的时间间隔，而在于及早纠正休克及迅速补充足够血容量。如果胎盘在分娩过程中剥离程度有限或当胎盘早剥经阴道分娩有扩展但胎儿已死亡、可疑生后不能成活也是胎盘早剥经阴道分娩指征。

Objective To discuss the indication and disposal of placental abruption in vaginal delivery and improve the pregnancy outcome .Methods The clinical data of 87 cases of placental abruption in vaginal delivery from Jan. 1993 to Feb. 2006 were retrospectively. Results There were 5 cases of newborn weak asphyxia ,2 cases of newborn heavy asphyxia , 12 cases of newborn death and 2 cases of stillbirth （with the newborn being given up ）,12 cases postpartum hemorrhage. There were no DIC, MOF or maternal death. Conclusions Placental abruption in vaginal delivery depends upon rectifying shock in time and the diligence with which adequate fluid and blood replacement therapy is pursed , rather than upon the interval to delivery . It also can be the indication of placental abruption in vaginal delivery which limited abruption or expanding abruption when the fetal died or was suspected to die after birth during delivery.