胎盘早期剥离31例临床分析

Clinical analysis of 31 cases of placental abruption

目的 :探讨胎盘早期剥离 (早剥 )的发病因素、临床表现及治疗。方法 :回顾性分析 31例胎盘早剥的临床资料、治疗及预后。结果 :胎盘早剥的发生率为 0 .8% ,机械性因素 17例 (5 4 .8% ) ,妊娠高血压综合征引起的 13例 (4 1.9% ) ,以中重度为主。临床症状主要以腹痛、阴道流血为多见 ,分别为 6 4 .5 %、5 4 .8% ,但有部分病例仅表现胎动消失或胎死子宫内 ,术前确诊较困难。临床类型轻重比例相近 ,病理类型以隐性和混合性多见 ,分别为 4 5 .2 %、5 1.6 %。分娩方式以剖宫产为主 (83.9% ) ,围生儿死亡率 5 4 .8%。结论 :胎盘早剥的发病因素以机械性因素和中重度妊娠高血压综合征为多见 ,临床表现以腹痛、阴道流血多见 ,围生儿病死率高 ,应做好孕期保健工作 ,积极推行孕期健康教育。

Objective:To study the causes,clinical features and treatment of placental abruption.Methods:The clinical data,treatment and outcome of 31 cases were reviewed.Results:The incidence of placental abruption was 0.8%,17 cases(54.8%) were caused by mechanical factors,and 13 cases(41.9%) by pregnancy induced hypertension syndrome(PIH).Most of which were moderate or severe PIH.The main clinical symptoms were vaginal bleeding and abdomen pain(64.5% and 54.8%,respectively).But some cases only showed fetal death inside uterus or fetal movement disappearing.It was difficult to diagnose before operation.The proportion of mild and severe type of the disease was near.The main pathology type was occult abruption or mixed hemorrhage( 45.2 % and 51.6%,respectively).The main delivery mode was cesarean section.The neonatal mortality was 54.8 %.Conclusions:The main causes of placental abruption were mechanical factors and moderate or severe PIH.The common symptoms of the disease were vaginal bleeding and abdomen pain.The neonatal mortality was high.It is suggested that pregnancy care and pregnancy health should be emphasized.