探讨43例不典型胎盘早剥漏诊原因及母胎预后

目的分析不典型胎盘早剥产前易漏诊的原因，改善母胎预后。方法回顾性分析17年间胎盘早剥产前未确诊的43例（观察组）患者的资料，并与同期产前确诊为胎盘早剥的63例（对照组）比较。结果观察组临床表现主要为腰酸、腹胀或胎心监护异常，早剥面积及总出血量均明显低于对照组。而死胎、死产、新生儿死亡、新生儿窒息及早产儿出生率与对照组比较差异无统计学意义。产科DIC等并发症与对照组比较差异无统计学意义。结论胎盘早剥漏诊的主要原因为发病诱因和临床症状不典型，虽轻型早剥占较大比例，但对母胎仍具有较大危害。

Analysis on the causes of missed diagnosis of atypical placental abruption in antepartum and the prognosis of the mothers and fetus

Objective To analyse the causes of missed diagnostic of atypical placental abruption and to improve the prognosis of mothers and fetus. Methods We retrospectively analyzed 43 cases of antepartum missed diagnostic atypical placental abruption from Jan 1990 to Dec 2006, and compared with 63 cases of antepartum diagnosed group. Results The main clinical presentations were waist acerbity, abdomen swell and abnormality of the fetal heart rate monitoring in antepartum missed diagnostic group. The area of placental abruption and the amount of bleeding were significantly lower than those of antepartum diagnosed group. However, there were no significant differences in the rate of stillborn fetus, fetal death, newborn death, asphyxia of newborn and DIC. between the two groups. Conclusion The main causes of missed diagnosis of atypical placental abruption are atypical inducement and atypically clinical presentation. Main atypical placental abruption belongs to light placental abruption, But it is still more harmful to both the mothers and fetus.