89例胎盘早剥临床分析

A clinical analysis of 89 cases of placental abruption

目的探讨胎盘早剥的病因、诊断及处理。方法对89例胎盘早剥进行回顾性分析，分别记录各组病因、临床症状及体征、分娩方式、产后出血量及病死率。结果本组病例平均失血量为392．50mL，其中42例出现失血性休克，输血患者67例，占75．28％；围产儿死亡率为26．97％。妊娠高血压疾病及慢性高血压病为胎盘早剥首要病因；外伤为胎盘早剥的第2位重要病因；慢性肾病史、子宫破裂也是胎盘早剥的诱因之一。结论对胎盘早剥要注意早期识别，动态观察，重视患者主诉，加强胎儿监测，及时诊断处理并积极加以预防，降低母儿围产期病死率。

Objective To explore etiology, diagnosis and treatment of premature separation of placenta（ placental abruption）. Methods The clinical data of 89 pregnant women with placental abruption were analysed retrospectively in terms of etiology, clinical symptoms and signs, delivery patterns, postpartum hemorrhage amount, and maternal mortality rate. Results The average blood loss of all pregnant women was 392.50mL. Hemorrhagic shock occurred in 42 eases, and 67 eases （75.28%） were given blood transfusion. The perinatal mortality rate was 26.97%. Hypertensive disorder complicating pregnancy or chronic hypertensive disease was leading cause of placental abruption and trauma was the second important eanse. Chronic nephropathies and uterine rupture were predisposing （incentive） causes of the disease. Conclusion The pregnant women with placental abruption should be identified as early as possible and monitored dynamically. The patient＇ s chief complain should be paid more attention. The fetal monitoring should be intensified. Timely diagnosis and management and active prevention are all necessary for reducing maternal and neonatal mortality rates.