妊娠晚期胎盘早剥43例回顾性分析

目的:分析不同分型的胎盘早剥的发病相关因素、首发临床征象、早期诊断情况及围产结局差异,旨在提高防治水平,降低危害程度。方法:将妊娠晚期43例胎盘早剥病例资料分成轻型组24例、重型组19例,对其发生的相关因素、首发临床征象、早期诊断情况及围产结局进行回顾性分析。结果:①重型组中妊娠期高血压疾病患病率居首位,显著高于轻型组(P<0.05);轻型组脐带过短和缠绕者居首位,显著高于重型组(P<0.05)。②重型组发病孕龄显著低于轻型组(P<0.05),首发临床征象以腹痛最多见,发生率显著高于轻型组(P<0.05);轻型组首发临床征象以阴道出血最多见,发生率显著高于重型组(P<0.05);重型组依靠临床征象、超声检查的诊断率均显著高于轻型组(P<0.05),轻型组的漏诊率显著高于重型组(P<0.05)。③重型组剖宫产率、围产儿死亡率显著高于轻型组(P<0.05);新生儿窒息率、产后出血、D IC发生率显著高于轻型组(P<0.05)。结论:轻型胎盘早剥和重型胎盘早剥在发生的相关因素、首发临床征象、早期诊断率及围产结局都存在差异。

Retrospective analysis on 43 cases of late pregnancy with placental abruption

Objective:To analyze the related factors,initial clinical signs,early diagnosis and perinatal outcomes of placental abruption of different types,improve the level of prevention and treatment and reduce the damages.Methods:43 cases of late pregnancy with placental abruption were divided into mild placental abruption group(24 cases) and severe placental abruption group(19 cases),the related factors,initial clinical signs,early diagnosis and perinatal outcomes of the two groups were analyzed retrospectively.Results:In severe placental abruption group,the incidence of hypertensive disorders complicating pregnancy(HDCP) was the highest,which was significantly higher than that in mild placental abruption group(P<0.05).In mild placental abruption group,the incidences of extreme shortness of umbilical cord and umbilical cord entanglement were the highest,which were significantly higher than those in severe placental abruption group(P<0.05).The gestational age of severe placental abruption group was significantly lower than that in mild placental abruption group(P<0.05).The most common initial clinical sign in severe placental abruption group was abdominal pain,its incidence was significantly higher than that in mild placental abruption group(P<0.05).The most common initial clinical sign in mild placental abruption group was vaginal bleeding,its incidence was significantly higher than that in severe placental abruption group(P<0.05).The diagnostic rates of clinical signs and ultrasound examination in severe placental abruption group were significantly lower than those in mild placental abruption group(P<0.05).The rate of missed diagnosis in mild placental abruption group was significantly higher than that in severe placental abruption group(P<0.05).The rate of cesarean section and mortality of perinatal infants in severe placental abruption group were significantly lower than those in mild placental abruption group(P<0.05).The incidences of neonatal asphyxia,postpartum hemorrhage and disseminated intravascular coagulation in severe placental abruption group were significantly lower than those in mild placental abruption group(P<0.05).Conclusion:There is significant difference in related factors,initial clinical signs,early diagnostic rate and perinatal outcomes between mild placental abruption and severe placental abruption.