148例胎盘早剥临床特征分析

Analysis of clinical characteristics of 148 cases of placental abruption

目的：分析胎盘早剥的发病因素及临床特征，探讨早期诊断要点，以提高早期诊断率，降低母儿并发症。方法收集本院自2012年3月~2014年2月期间收治的148例胎盘早剥患者的临床资料，回顾性分析其血压、阴道流血、腹痛、有无合并胎膜早破、超声表现、胎心监测情况。结果148例患者中，诊断为妊娠期高血压或子痫前期的占16.9%；血压范围在125~140/80~90 mmHg的占41.2%；合并胎膜早破者占30.4%；出现产前出血或血性羊水的占62.2%；表现为无间歇的持续性下腹痛及子宫压痛者占15.5%；超声检查提示胎盘早剥表现的占26.4%；表现为II类胎心监测图形的占68.2%。结论妊娠期高血压包括临界高血压、胎膜早破是胎盘早剥发病的危险因素；产前出血或血性羊水、II类胎心监测图形是胎盘早剥的重要临床表现，而腹痛症状多不典型；超声对胎盘早剥的诊断价值有限，只能作为辅助检查手段。

Objective To analyze the risk factors and clinical features of placenta abruption, explore the key points for early diagnosis and improve the acuracy of early diagnosis.MethodsRetrospectively analyzing the clinical aspects of 148 placental abruption patients, including blood pressure, vaginal bleeding, abdominal pain, premature rupture of membranes, sonography and fetal heart rate trace.ResultsOf the 148 patients, 16.9% was complicated by gestational hypertention or preeclampsia; the blood pressure of 41.2% patients ranges 125-140/80~90 mmHg; 30.4% was complicated by PROM; 62.2% showed antepartum hemorrhage; 26.4% had abnormal sonograph results; 68.2% showed type II fetal heart rate trace.ConclusionGestational hypertension including bordering hypertension and PROM are risk factors of placental abruption; antepartum hemorrhage and type II fetal heart rate trace are most important clinical symptoms, while abdominal pain is often not typical; sonography has a limited diagnostic value for placental abruption.