胎盘早剥61例分析

An analysis of 61 cases of placental abruption

目的 探讨胎盘早剥的早期诊断及处理要点.方法 对北京市房山区妇幼保健院2003年12月～2008年12月住院分娩的患者5 326例并发生61例胎盘早剥临床资料进行回顾性分析.结果 胎盘早剥发生率为1.1%（61/5 326）,产前确诊率为49.2%（30/61）.发病诱因为妊娠期高血压综合征28例（45.9%）,机械因素15例（24.6%）,胎膜早破10例（16.4%）,羊水过多2例（3.3%）,原因不明6例（9.8%）;产妇发生产后出血占41.0%（25/61）,肾衰占3.3%（2/61）,弥散性血管内凝血占4.9%（3/61）.无孕产妇死亡病例,围产儿死亡率为31.1%（19/61）.结论 对胎盘早剥的诱因、临床表现及实验室检查进行综合分析,尽早做出诊断,立即终止妊娠可改善母儿的预后.

Objective To investigate early diagnosis and proper treatment of placental abrnption. Methods The clinical data of 61 pregnant women with placental abruption among 5 326 pregnant women who delivered in Fangshan District Maternal and Child Health Hospital in a period from Dec. , 2003 to Dec. , 2008 were analyzed retrospectively. Results The incidence rate of placental abruption was 1.1% （61/5 326） and the final diagnosis rate before delivery was 49.2% （30/61）. The causative factors included hypertensive disorder complicating pregnancy in 28 pregnant women （45.9%）, mechanical factors in 15 pregnant women （24.6%）, premature rupture of membranes in 10 pregnant women （ 16.4% ）, polyhydramnios in 2 pregnant women （ 3.3% ） and unknown causes in 6 pregnant women （9.8%）. The incidence rates of postpartum hemorrhage, renal failure and DIC were 41.0% （25/61）, 3.3% （2/61） and 4.9% （3/ 61 ）, respectively. No maternal mortality occurred. The death rate of perinatal infant was 31.3% （ 19/61 ）. Conclusion Integratedly analyzing the causative factors of placental abruption, clinical manifestations of the patients, making the diagnosis as early as possible and immediately terminating pregnancy all can improve prognoses of mother and the infant.