胎盘早期剥离13例分析

目的探讨胎盘早期剥离(胎盘早剥)的产前诊断和处理。方法对我院近10年发生的13例胎盘早剥作回顾性分析。结果妊高征及慢性高血压病占本组病因的46．2％。本组围产儿死亡率为23．08％，孕产妇死亡率为0。子宫卒中发生率46．15％，产后出血30．77％，DIC 7．70％。阴道出血、腹痛、胎心异常或消失、血性羊水为主要临床表现。产前诊断率为46．15％，B超检出率为60％。结论胎盘早剥的诊断需结合患者临床表现、发病诱因、B超检查结果全面考虑，确诊后应尽快终止妊娠。

Clinical analysis of 13 cases of placental abruption

Objective To discuss the prenatal diagnosis and management of placental abruption.Methods Thirteen patients with placental abruption were reviewed.Results Pregnancy-induced hypertension syndrome and chronic hypertension were the main pathogeny of this disease(46.2%).The perinatal death rate in this group was 23.08%,while maternal mortality rate was 0.The incidence of uterine apoplexy was 46.15% and that of postpartum hemorrhage was 30.77%,and DIC was 7.70%.Vaginal hemorrhage,pain in lower abdomen,abnormality or disappearance of fetal heart rhythm,and bloody amniotic fluid were the four main clinical manifestations.The accuracy of prenatal diagnosis in this group was 46.15%,and the sensitivity of ultrasonographic diagnosis was 60%.Conclusion The diagnosis of placental abruption needs comprehensive analysis with clinical symptoms pathogeny and accessory examinations such as ultrasonography.Once the disease is diagnosed as placental abruption,the pregnency should be stopped.