胎盘早剥的早期临床诊断

Analysis on early clinical diagnosis of placental abruption

目的探讨胎盘早剥临床漏诊的原因,提高胎盘早剥的早期诊断。方法对近5年在我院产科发生的40例胎盘早剥的临床资料进行回顾性分析。结果胎盘早剥的发生率为0.60%。19例合并妊娠高血压疾病(47.5%),16例孕妇没有任何胎盘早剥的高危因素(40%)。大部分孕妇临床表现不典型。前壁胎盘B超诊断率高于后壁胎盘(P<0.05),重度胎盘早剥B超诊断率高于轻度胎盘早剥(P<0.05)。结论识别胎盘早剥的高危因素,根据病史、临床症状和体征,结合B超以及电子胎心监护,进行综合分析判断是提高胎盘早剥诊断的有效手段。

Objective To investigate the reasons of miss diagnosis of placental abruption in order to enhance its early clinical diagnostic rate.Methods The clinical records of 40 women with placental abruption who delivered in the Department of Obstetrics of our hospital in the 5 years period were retrospectively reviewed.Results The incidence of placental abruption was 0.6%.Nineteen cases were complicated with hypertensive disorders in pregnancy（47.5%） and 16 without any high risks of placental abruption（40%）.Most of the patients presented untypical manifestation.Significantly higher diagnosis rate was made by ultrasound for anterior-wall placenta than posterior-wall placenta（P〈0.05）.The ultrasound diagnostic rate of severe cases was statistically higher than mild ones（P〈0.05）.Conclusions Identifying the risk factors and analyzing the clinical symptoms,physical signs,ultrasound scan and electronic fetal heart rate monitoring may improve the early diagnosis rate of placental abruption.