胎盘早剥并发子宫胎盘卒中的危险因素及围产结局分析

Analysis of risk factors and perinatal outcomes of placental abruption complicated with uteroplacental apoplexy

目的 探讨胎盘早剥并发子宫胎盘卒中的发病危险因素、临床特征及母儿结局.方法 将53例胎盘早剥患者按是否并发子宫胎盘卒中分为观察组和对照组,进行回顾性分析比较.结果 两组在诊断时间（χ2=4.681,P〈0.01）、外伤史（P〈0.01）及发病持续时间（t=2.868,P〈0.01）方面有统计学差异;临床特征比较,观察组腹痛、血性羊水、子宫张力高均明显高于对照组（χ2腹痛=6.756、χ2血性羊水=9.729、χ2子宫张力高=14.174,均P〈0.01）;在胎盘剥离面积〉1/3（χ2=20.071,P〈0.01）、发生产后出血（χ2=19.881,P〈0.01）、DIC（χ2=16.110,P〈0.01）、死胎及早期新生儿死亡发生率（χ2=19.881,P〈0.01）两组有统计学意义.结论 胎盘早剥并发子宫胎盘卒中发病危险因素与发病持续时间及外伤有关,其母儿结局不良.

Objective To study the risk factors, clinical characteristics and outcomes of placental abruption complicated with uteroplacental apoplexy. Methods 53 cases of placental abruption were divided into two groups： observation group （ complicated with uteroplacental apoplexy） and control group, and the outcomes were retrospectively analyzed and compared. Results The diagnosis time （χ2 = 4.681 ,P 〈 0.01 ）, traumatic history （P 〈 0.01 ） and disease duration （ t = 2. 868, P 〈 0.01 ） were significantly different between two groups. The number of cases with abdominal pain, bloody amniotic fluid and high uterine tension in observation group was obviously higher than that in 2 7 2 2 control group （Xabdominal pain = 6. 756 ,χbloody amniotie fluid = 9. 729 ,χhigh uterine teosion = 14. 174, all P 〈 0.01 ）. In addition, the cases with placenta abruption area 〉 1/3 （χ2 = 20. 071, P 〈 0.01 ）, postpartum hemorrhage （χ2 = 19. 881, P 〈 0.01 ）, DIC （χ2 = 16. 110, P 〈 0.01 ）, stillbirth and early neonatal death rate （χ2 = 19. 881, P 〈0.01 ） in observation group were significantly more than those in control group. Conclusion Long duration of disease and traumatic history are risk factors of placental abrnption complicated with uteroplacental apoplexy, which lead to poor maternal-fetal prognosis.