32例胎盘早剥临床分析

Clinical Analysis of Placental Abruption in 32 Cases

目的了解胎盘早剥患者的致病因素、临床表现、诊断及母婴结局。方法回顾性分析32例胎盘早剥患者临床资料,分析其发病诱因、临床表现、超声诊断及母婴结局情况。结果 32例胎盘早剥患者有明确发病诱因的27例,以妊娠期高血压疾病、机械性因素等为主;其主要临床表现为血性羊水、阴道出血、腰腹痛、胎心异常等;重型胎盘早剥超声诊断符合率、剖宫产率、发生产后出血、子宫胎盘卒中者高于轻型胎盘早剥,两组差异有统计学意义(P<0.05);重型胎盘早剥患者发生弥散性血管内凝血(DIC)者围产儿发生新生儿轻度窒息率、围产儿病死率高于轻型胎盘早剥患者,两组差异无统计学意义(P>0.05);重型胎盘早剥患者围产儿发生新生儿重度窒息、转新生儿监护室高于轻型胎盘早剥,两组差异有统计学意义(P<0.05)。结论胎盘早剥的临床表现各异;超声检查阴性不能除外胎盘早剥;如合并不明原因阴道出血增多、胎心异常时需高度警惕;及时处理与母婴预后密切相关。

Objective To analyze the predisposing factors of placental abruption,clinical manifestation,diagnosis,and pregnancy outcome. In order to increase the diagnosis rate and reduce the complications of pregnancy. Methods The clinical data of 32 cases with placental abruption were retrospectively reviewed. To analyze the predisposing factors,clinical manifestation,diagnosis,and pregnancy outcome.Results 27 cases had the main predisposing factors,mainly including hypertensive disorders complicating pregnancy,mechanical factors. The main clinical manifestations included bloody amniotic fluid,vaginal hemorrhage,lower abdomen pain,abnormal fetal heart rate. Compared with the light placental abruption,diagnostic accuracy of ultrasound unsevered placental abruption were significantly higher( P <0. 05). Compared with the light placental abruption,cesarean section rate,postpartum hemorrhage,uteroplacental apoplexy,severe asphyxianeonatorum,newborn stransfered to neonatal department insevere placental abruption were significantly higher( P < 0. 05). There was no significant difference between light placental abruption and severe placental abruption in DIC,Neonatal asphyxia,perinatal death.Conclusion The clinical manifestation of placental abruption were various; the ultrasound negative can not exclude. It needs to be alerted when unexplained vaginal hemorrhage,abnormal fetal heart rate.Timely treatment is closely related to the prognosis of mothers and children.