胎盘早剥合并弥漫性血管内凝血急诊处理

Emergency treatment of placental abruption combined DIC

胎盘早剥是妊娠中晚期的严重并发症,合并弥漫性血管内凝血(DIC)时,可导致孕产妇和围产儿的发病率及死亡率明显增加,早期诊断和急诊处理是改善围产结局的关键。急诊处理胎盘早剥合并DIC的主要措施在于维持血容量,补充凝血因子,并及时终止妊娠。胎儿存活者应剖宫产终止妊娠,胎儿已死亡者可考虑经阴道分娩。

Abruptio placentae is a serious complication in the latter half of pregnancy. When placental abruption is combined with disseminated intravascular coagulation （DIC）, it can lead to significantly increased maternal and perinatal morbidity and mortality. At that timel early diagnosis and treatment are the key to to improve perinatal outcomes. Restoring the circulating volume, supplying blood coagulation factor and ending pregnancy timely are the main treatment measures of the emergency managemen. Cesarean sections were needed most often when the diagnosis is clear and the fetus alive and viable, while aggressive resuscitation and expeditious vaginal delivery are the goals when the fetus is dead.