不典型胎盘早剥的临床探讨

Analysis on the Clinical Features of Atypical Placental Abruption

目的探讨不典型胎盘早剥的发病诱因、高危因素及临床表现,提高早期诊断率,尽可能降低母婴不良结局。方法回顾分析我院2016年1-12月收治的201例诊断胎盘早剥患者的临床资料,其中不典型胎盘早剥91例(观察组),产前诊断胎盘早剥110例(对照组)。结果观察组的催产素或其它引产方式引产、疤痕子宫的发生率高于对照组(P<0.05),妊娠期高血压疾病、外伤史发生率低于对照组(P<0.05)。观察组胎监异常、子宫高张、持续性腹痛、阴道出血、血性羊水的发生率低于对照组(P<0.05),先兆早产或临产、宫缩频强或产程短的比例高于对照组(P<0.05)。观察组剖宫产、新生儿窒息发生率均低于对照组(P<0.05)。结论规范使用缩宫素、重视疤痕子宫患者,加强先兆早产、妊娠期高血压疾病的监测,动态观察病情变化,有助于早期诊断,降低不良结局。

Objective To analysis the pathogenic factors, high risk factors sand clinical features of atypical placental abruption, to enhance early diagnosis rates, reduce adverse outcomes of maternal and infant. Methods Retrospective analysis was conducted on 201 placental abruption cases in our hospital from January to December 2016, including 91 atypical placental abruption （observational group） and 110 prenatal diagnosis of placental abruption （control group）. Results The incidence of oxytocin or other induced labor, scarred uterus in observational group was higher than that in the control group （P 〈 0.05）. And the incidence of hypertensive disorder complicating pregnancy, history of trauma were lower than the control group （P 〈 0.05）. The proportions of abnormal fetal heart rate, hypertonic uterine, persistent abdominal pain, vaginal bleeding, and bloody amniotic fluid of the observational group were lower than the control group （P 〈 0.05）. The proportions of threatened premature labor or near-labor, higher uterine contraction frequency or shorter labor coursewere higher than the control group （P 〈 0.05）. The incedence of cesarean section, perinatal death were lower than the control group （P 〈 0.05）.Conclusion We should standardize the use of oxytocin to prevent frequent and strong contractions, pay attention to the threatened labor of scarred uterus, threatened preterm labor and hypertensive disorders in pregnancy, and observe the illness dynamically so as to early diagnose the disease and reduce complications.