妊娠晚期绒毛膜后巨大血肿的临床分析

Clinical analysis of massive subchorionic hematoma in late pregnancy

目的:探讨孕晚期发现的绒毛膜后巨大血肿的临床表现、诊断及治疗。方法:回顾性分析北京大学第三医院2004年7月～2009年2月7例绒毛膜后巨大血肿的临床资料,对其临床表现、超声影像学的诊断和临床治疗经过进行分析。结果:绒毛膜后巨大血肿的特征性临床表现为阴道流血及腹痛,需要与胎盘早剥进行鉴别,通过超声检查、产时情况及胎盘检查明确诊断。治疗采用个体化原则,根据临床表现及孕周情况决定终止妊娠时间和方式。结论:绒毛膜后巨大血肿临床上易发生误诊,需要加强监测,适时终止妊娠,从而减少严重并发症的发生,改善母儿预后。

Objective： To explore the clinical manifestations, diagnosis and treatment of massive subehorionic hematoma in late pregnancy. Methods： Clinical data of 7 cases with massive subchorionic hematoma in late pregnancy in the hospital from July 2004 to February 2009 were analysed retrospectively, the clinical manifestations, diagnosis of ultrasound and treatment were analysed. Results： The characteristic clinical manifestations of massive subchorionic hematoma included vaginal bleeding and bellyache, which needed to be distinguished from placental abruption by uhrasonography, dellvery observation and placental examination. The principle of individualization was adopted in the treatment, the time and modes of pregnancy termination were decided according to clinical manifestations and gestational weeks. Conclusion： Misdiagnosis is prone to occur in patients with massive subchorionic hematoma, intensive monitoring, timely termination of pregnancy may reduce the incidence of severe complications and improve perinatal outcomes.