复发性胎盘早剥的临床分析

目的 素与前次时相同,与妊娠高血压疾病（PIH）有关;1例前次胎盘早剥不伴有妊娠期高血压疾病、子宫畸形-双角子宫的复发时却出现子痫前期且为3次胎盘早剥.（3）复发性胎盘早剥胎盘剥离程度加重,弥散性血管内凝血障碍（DIC）发生率增加,而产后出血﹑子宫胎盘卒中﹑急性肾衰﹑急性呼吸窘迫综合征（ARDS）的发生率没有增加.结论 复发性胎盘早剥的可能发病因素主要是妊娠期高血压疾病、子宫畸形,发生时间提前,胎盘剥离程度加重,母儿结局不佳.

Clinical analysis of recurrent placental abruption

Objective： To analyze the pathogenic factors, clinical characteristics and pregnancy outcomes of recurrent placental abruption. Methods： A retrospective study of 6 cases of recurrent placental abruption who had delivered in our hospital from Jan. 2003 to Aug. 2009 was conducted to investigate the possible risk factors, clinical characteristics and pregnancy outcomes. The difference in clinical characteristics between recurrent cases and their initial cases was examined. Results： The incidence of recurrent placental abruption was 0.01% （6/59,214）. Compared with the initial cases, the recurrent cases had an earlier onset and lasted longer, with natural delivery in most cases. Three recurrent cases were related to pre-eclampsia, same as the previous ones and 1 case related to uterine malformation. In recurrent cases, the grade of placental abruption got severe and the incidence of disseminated intravascular coagulation （DIC） increased, but the incidences of postpartum hemorrhage, uteroplacental apoplexy, acute renal failure or acute respiratory distress syndrome （ARDS） did not increase. Conclusions： Among the risk factors of recurrent placental abruption were pre-eclampsia and uterine malformation. Earlier onset and extended abruption were observed in recurrent placental abruption, with adverse maternal-fetal outcomes.