胎盘早剥早期诊断对母儿预后的影响及其危险因素分析

Effect of early diagnosis of placental abruption on the prognosis of mothers and infants and the risk factors analy-sis

目的：探讨胎盘早剥的早期诊断对母儿预后的影响及其危险因素。方法回顾性分析42例胎盘早剥患者的临床资料，探讨其早期诊断方法，并选择同期42例正常孕产妇，分析胎盘早剥的危险因素。结果仅用B超检查确诊率为67.5%，胎心监护异常联合B超检查确诊率为80.0%，差异有统计学意义（ P﹤0.05）。胎盘早剥组孕产妇中高龄患者、高血压、吸烟史、羊水异常及胎膜早破等的发生率明显高于对照组，差异有统计学意义（P﹤0.05）。轻型胎盘早剥孕妇无一例患者发生围产儿死亡，重型胎盘早剥孕妇围产儿宫内死胎发生率为10.0%，胎儿死亡发生率为15.0%，两组围产儿死亡率比较差异有统计学意义（ P﹤0.05）。结论胎心监护联合B超检查可明显提高胎盘早剥诊断率，胎盘早剥的程度严重影响着母儿的预后。因此提高胎盘早剥的早期诊出率，及时有效地处理危险因素，可降低孕妇、围产儿的死亡率。

Objective To investigate the early diagnosis of placental abruption on the prognosis of mothers and infants and the risk factors. Methods The clinical data of 42 patients with placental abruption were retrospectively analyzed,the early diagnosis methods were studied. In the same period,42 cases of normal maternal were chose,the risk factors of placental abruption were analyzed. Results The diagnosis rate of B-ultrasound was 67. 5%,and the diagnosis rate of abnormal fetal heart rate monitoring combined with B ultrasound was 80. 0%,there was significant difference（ P ﹤0. 05）. The incidences of elderly patients,hypertension,smoking history,amniotic fluid abnormalities,premature rupture of fetal membranes and other factors were higher in the placental abruption group than those in the control group,there were significant differences（ P﹤0. 05）. There was no perinatal death in patients with light placental abruption,and the intrauterine fetal death rate was 10. 0% and the fetal death rate was 15. 0% in patients with severe placental abruption,there was significant difference in the perinatal mortality between the two groups（ P﹤0. 05 ）. Conclusions B-ultrasound combined with fetal heart rate monitoring can obviously improve the diagnosis rate of placental abruption,the degree of placental abruption has severe impact on the prognosis of mothers and infants. Therefore,increasing the early diagnosis rate of placental abruption,timely and effective treatment of the risk factors,can reduce the maternal perinatal mortality.