妊娠高血压综合征并发胎盘早剥32例临床分析

目的探讨妊娠高血压综合征并发胎盘早剥的相关影响因素及妊娠结局。方法选取我院2010年1月至2013年8月妇产科收治的妊娠高血压综合征孕妇64例,根据有无并发胎盘早剥分为胎盘早剥组和无胎盘早剥组各32例。比较两组孕妇的年龄、血细胞比容、分娩方式及分娩结局的差异。结果胎盘早剥组和无胎盘早剥组孕妇在年龄方面比较,差异无统计学意义（P〉0.05）;两组孕妇血细胞比容比较,差异有统计学意义（P〈0.05）;两组孕妇分娩方式比较,胎盘早剥组剖宫产25例,阴道分娩7例,无胎盘早剥组剖宫产17例,阴道分娩15例,统计学有显著性差异（P〈0.05）;两组分娩结局（胎儿窘迫、新生儿窒息及死胎率）等比较,胎盘早剥组远高于无胎盘早剥组,差异有统计学意义（P〈0.05）。结论胎盘早剥是妊娠晚期孕妇较为严重的并发症,其起病急、病情进展迅速,其中剖宫产术也是其危险因素之一,因此加强产前检查,积极防治妊高症是预防胎盘早剥的关键,早期诊断并及时给予相应的临床处理可降低妊娠高血压综合征并发胎盘早剥的病死率,改善孕妇及胎儿的预后。

Clinical analysis of 32 cases of pregnancy- induced hypertension syndrome complicated by placental abruption

Objective Investigate related factors and pregnancy outcome of pregnancy- induced hypertension complicated by placental abruption. Methods 64 cases of pregnant women suffered from pregnancy induced hypertension and admitted in obstetrics department in our hospital during January 2010 and August 2013 were enrolled in the study,and they were divided into two groups according to whether complicated by placental abruption,32 cases in each group. Compared the differences of age,hematocrit,delivery mode and birth outcomes between the two groups. Results The difference of age between the two groups was not statistically significant（ P 〉0. 05）. And the difference of hematocrit of the two groups was statistically significant（ P 〈0.05）. 25 cases chose cesarean section and seven cases of vaginal delivery in placental abruption group,and in ono- abruption group,17 cases chose cesarean section and 15 cases of vaginal delivery,the difference was statistically significant（ P 〈0. 05）. Adverse pregnancy outcomes（ fetal distress,neonatal asphyxia and stillbirth rates） placental abruption group were significantly higher than those in non- abruption group,the differences were statistically significant（ P 〈0. 05）. Conclusions Early placental abruption is a serious complication for pregnant women in late pregnancy for its rapid onset and progression,and cesarean section is one of the risk factors,thus strengthening prenatal care and positive preventing pregnancy- induced hypertension is the key stripping of preventing placenta abruption,early diagnosis and timely treatment can reduce the mortality caused by pregnancy- induced hypertension complicated by placental abruption,improve maternal and fetal outcomes.