31例不典型胎盘早剥临床诊断及分析

目的探讨不典型胎盘早剥的临床诊断方法,以减少漏诊、误诊率,降低孕产妇和围产儿病死率。方法回顾性分析产科2005年1月～2009年12月接诊的31例不典型胎盘早剥病例的临床资料。结果不典型胎盘早剥占胎盘早剥病例的58.5%,其中74.2%为轻型胎盘早剥,合并胎儿宫内生长受限占29%,产前诊断18例,漏诊误诊13例,诊断准确率为58.1%。结论不明原因的早产、阴道出血、胎儿窘迫均应考虑胎盘早剥可能,胎儿宫内生长受限(FGR)可能是胎盘早剥的潜在病因,连续动态的临床监测可提高不典型胎盘早剥的诊断准确率,降低孕产妇和围产儿的发病率和死亡率。

Objective Explore the clinical diagnostic method of atypical placental abruption,to reduce the rate of misdiagnosis and missed diagnosis,and to reduce the maternal and prenatal morbidity and martality.Methods Retrospective obstetrics since January 2005-December 2010,the clinical data of 31 cases of atypical placental abruption were analyzed.Results The atypical placental abruption is about 58.5% of placental abruption cases.74.2% are mild cases.29% cases with FGR.18 cases were diagnosed before labor;13 cases were misdiagnosed;the accurate diagnosis rate is about 58.1%.Conclusion No reason of preterm labor,vaginal bleeding an d fetal distress must thinking about the possibility of placental abruption.So FGR is probably of one basic reason of placantal abruption.Continued mornitor will improve the accurate diagnosis rate of placental abruption and decrease the maternal and prenatal morbidity and martality.