不典型胎盘早剥早期临床诊断探讨

目的：探讨不典型胎盘早剥的临床特点,以提高其早期诊断率,改善母婴预后。方法：2007年1月—2009年12月收治8 700例住院孕产妇,其中胎盘早剥61例,按产前是否明确诊断分为不典型胎盘早剥病例组（观察组）34例,产前诊断胎盘早剥病例组（对照组）27例,进行临床分析。结果：胎盘早剥发生率0.7%,漏诊率为55.7%。结论：不典型胎盘早剥发生率高,发病诱因不明显,临床症状不典型,B超阴性是其漏诊的主要原因。只有注重病史,仔细体检,动态观察,综合分析,提高警觉,提高不典型胎盘早剥的早期诊断率,及时处理,才能降低孕产妇死亡率和围产儿死亡率。

The primitive clinical diacritical discuss of atypical placental abruption

Objective：To investigate the atypical clinical features of placental abruption,to improve early diagnosis rates,improving outcomes of maternal and infant.Methods：Eight thousands and seven hundreds hospitalized pregnant and lying-in women were accepted from January 2007 to December 2009.61 cases were placental abruption,according to whether or not clear diagnosis,all cases was divided into two groups.Atypical placental abruption group（observational group）in 34 cases,prenatal diagnosis of placental abruption case group（control group）in 27 cases.Results：The incidence rate was 0.7%,the missed rate was 55.7%.Conclusion：The incidence of atypical placental abruption is high.Predisposing factors is not evident,the clinical symptoms is atypical,negative of type B ultrasonic is the leading cause of missed,paying attention to history,careful physical examination,observation,analysis and raising alert can improve the rate of early diagnosis of atypical placental abruption,timely processing can we truly achieve lower maternal and perinatal mortality.