胎盘早剥的早期诊断及治疗(附34例分析)

Early diagnosis and treatment of placental abruption(34 cases analysis)

目的总结不典型胎盘早期剥离的临床特点,探讨早期诊断、处理要点。方法回顾性分析2003年1月～2007年7月胎盘早剥34例患者资料。结果胎盘早剥发生率为0.65%,妊娠期高血压仍是最常见的诱因。34例胎盘早剥患者中,B超检查者26例（76.47%）,有异常发现19例（73.08%）,11例无明显临床症状仅有胎心异常,局部轻压痛或腰骶酸痛,在产后和术后检查胎盘发现。结论B超检查是诊断胎盘早剥的重要手段,但对B超检查胎盘无异常发现的无原因的胎心变化伴产兆,或伴局部轻压痛、腰骶酸痛应考虑胎盘早剥可能。

Objective To summarize the clinical manifestation and explore the early diagnosis and essential management of atypical placental abruption. Methods A retrospective analysis was done in 34 cases of placental abruption from Jan 2003 to July 2007. Results The incidence of placental abruption was 0.65%. Pregnancy induced hypertension syndrome （PIH） was still the familiar risk factor of placental abruption. Of the 34 cases,26（76.47% ）were examined by trasonography and 19（73. 08% ）were diagnosed as abnormal by trasonography. Eleven cases which were diagnosed as placental abruption by checking placental after delivery or operation didn＇t have obvious clinical manifestation, and they had only abnormal fetal heart rate, mild pain in locality by press. Conclusion Trasonography is the important instrument for diagnosing placental abuption. For the cases with abnormal fetal heartrate, mild ache in locality by press or sacrolumbarsore, we should consider the possibility of placental abruption after excluding other possible diseases, although they have no abnormity in trasonography.