胎盘早剥25例临床分析

目的:探讨胎盘早剥的发病原因、胎盘早剥与妊高症及急性弥漫性血管内凝血(DIC)的关系。方法:对2000年1月-2004年7月25例胎盘早剥患者的临床资料进行回顾性分析。结果:(1)25例胎盘早剥患者的发病原因主要是妊高症、机械性因素(包括私人不恰当操作)、羊水过多、胎膜早破;(2)25例胎盘早剥患者中妊高症10例(40%),重度妊高症6例(24%);(3)25例胎盘早剥患者并发DIC6例(24%);(4)25例胎盘早剥患者中死胎5例(20%),新生儿死亡2例(8%),死产1例(4%),新生儿窒息5例(20%),孕产妇死亡1例(4%),次全子宫切除5例(20%),产后出血9例(36%)。6例并发DIC患者中死胎4例(66.7%),新生儿重度窒息1例(16.7%);产妇死亡1例(16.7%),次全子宫切除4例(66.7%)。结论:胎盘早剥是严重威胁孕产妇及胎儿生命的妊娠晚期并发症,尤其是重度妊高症诱发的胎盘早剥,易并发急性DIC,威胁母婴安全。

Clinical Analysis of 25 Cases with Placental Abruption

Objective: To investigate the etiology of placental abruption, and the relationship between placental abruption and preeclampsia or acute Disseminated inravascular coagulation (DIC). Methods: The clinical data of 25 patients with placental abruption who were treated emergently from Jan. 2000 to Jul. 2004 in our hospital were analyzed retrospectively. Results: (1) The major etiology of placental abruption was preeclampsia,mechinal agent(involve private inappropriate operation),hydramnios and premature rupture of membranes. (2) Preeclampsia was found in 10 patients(40%)and severe preeclampsia was found in 6 patients(24%). (3) 6 patients complicated DIC. (4)In 25 placental abruption cases,5 fetal death(20%),2 neonatal death(8%),l stillbirth(4%), 5 neonatal asphyxia(20%),l maternal death (4%), 5 subtotal hysterectomy(20%) ,9 postpartum hemorrhage. In 6 cases, which complicated DIC, 4 fetal death (66. 7%), 1 severe neonatal asphyxia (16.7%), 1 maternal death (16. 7), 4 subtotal hysterectomy (66.7%). Conclusion:Placental abruption is the severe complication in late pregnancy period, which fatally threatens maternal and fetal life. Especially the cases induced by severe preeclampsia, which were easy to complicate acute DIC, and threaten maternal and fetal safety.