子宫后壁胎盘早剥的早期识别与预后分析

Forepart distinction and prognosis analysis of placental abruption in the lateral walls of uterus

目的:探讨子宫后壁胎盘早剥的早期识别、并发症及围产儿死亡率与病情的关系。方法:用回顾性分析方法对5年间子宫后壁胎盘早剥63例(观察组)进行分析,并与同期子宫前壁胎盘早剥的59例(对照组)比较。结果:观察组多无典型的症状,有些表现为腰痛和阴道出血,产前B超发现阳性率为51.22%,剖宫产40例,阴道产23例,新生儿窒息12例(19.05%),死胎1例(1.59%),死产0例;围产儿死亡率为1.59%。对照组主要表现为腹痛和阴道出血;产前B超发现阳性率为78.26%,剖宫产29例,阴道产30例,新生儿窒息7例(11.86%),死胎0例,死产0例,围产儿死亡率为0%。均无子宫卒中及子宫次全切除出现,无孕产妇死亡。结论:重视胎盘早剥诱因及临床表现,结合B超和实验室等辅助检查,早期识别,及时有效的临床处理可降低孕产妇和围产儿死亡率。

Objective： To detect the relationship of early recognized placental abruption in uterus posterior wall, its complication and perinatal mortality rate with the pathogenetic condition. Methods： 63 cases of placental abruption in posterior uterine wall （ the observation group） in 5 years were analyzed using retrospective method to compare to 59 cases of placental abruption in anterior uterine wall （ the control group） at the same time. Results： The observation group had no typical symptom, some had low back pain and colporrhagia, ultrasound antepartum detected the masculine rate was 51.22%, 40 cases of uterine - incision delivery, 23 cases of normal labor, 12 cases of newborn asphyxy （ 19.05% ） , 1 case of fetal death （ 1. 59% ） , no case of dead birth, perinatal mortality rate 1.59%. The control group showed mainly the abdominal pain and colporrhagia, ultrasound antepartum detected the masculine rate was 78. 62%, 29 cases of uterine - incision delivery, 30 cases of normal labor, 7 cases of newborn asphyxy （ 11.86% .）, no case of fetal death, no case of dead birth, perinatal mortality rate 0%. Both had no apoplexia uteri case, no subtotal ectomy, no maternal death. Conclusion： Attention should be paid to the motivation and the clinical manifestation of placental abruption, binding ultrasound and laboratory auxiliary examination, discrimination early, prompt and effective clinical procedures to depress the pregnant -parturient and perinatal mortality rate.