绒毛膜下血肿对先兆流产和早产妊娠结局的影响

Influence of subchorionic hematoma on pregnancy outcome of threatened abortion and premature delivery

目的 探讨绒毛膜下血肿对先兆流、早产妊娠结局的影响。方法 对 70例先兆流、早产经超声波诊断有绒毛膜下血肿的临床表现进行回顾性分析。结果 绒毛膜下血肿的主要临床表现为阴道流血 (10 0 % ) ,腹痛 (34 2 9% )。出现血肿的平均孕龄为 14 3± 5 6w ,其中最早孕龄为 8w ,最晚孕龄为 2 5w。妊娠结局为流产者 2 2例 (31 4 3% ) ,其中早期流产 7例 ,晚期流产 15例 ;早产者 15例 (19 0 5 % ) ,其中合并胎儿宫内生长迟缓者 2例 ,胎膜早破者 6例 ;死胎者 6例 (8 5 7% ) ,其中合并胎盘早剥及子宫卒中者 1例 ;足月妊娠为 2 7例 (38 5 7% )。结论 绒毛膜下血肿出现早且血肿小 ,妊娠结局多良好 ,而血肿出现晚且血肿大 ,妊娠结局多不良。

Objective: In order to investigate the influence of subchorionic hematoma on the pregancy outcome of threatened abortion and premature delivery. Methods: We chose 70 cases of threatened abortion and premature delivery which had been diagnosed as subchorionic hematoma by ultrasonic examination and made retrospective analysis for the clinical manifestations of these cases. Results: The main clinical manifestations of subchorionic hematoma were vaginal bleeding (100%) and abdominal pain(34.29%). The average occurring time of hematoma were 14.3±5.6 gestational weeks and the earliest one was the 8th gastational week, the latest one was the 25th gestational week. The pregnant results included 22 cases of abortion (31.43%) which were composed of 7 cases of abortion in early stage and15 cases of abortion in late stage, 15 cases of premature delivery (19.05%) in which there were 2 case complicated with IUGR and 6 cases complicated with premature rupture of membranes, 6 cases of fetal death (8.57%) in which there were 1 case complicated with placental abruption and uterin apoplexy, 27 cases of mature prgnancy (38.57%). Conclusion: If the subchorionic hematoma occur early and are small, the pregnancy usually have good outcome. If the subcorionic hematoma occur late and are large, the pregnancy usually have bed outcome.