重度子痫前期并发胎盘早剥46例临床分析

目的:探讨重度子痫前期并发胎盘早剥患者的临床特征及母婴预后。方法:以重度子痫前期并发胎盘早剥46例为观察组,同期重度子痫前期未并发胎盘早剥的383例为对照组,比较临床特征及母婴结局。结果:观察组分娩孕周(33.7±4.0)周明显小于对照组(35.6±3.8)周,差异有统计学意义(P<0.05)。观察组产前出血、强直宫缩、胎儿窘迫胎死宫内高于对照组,观察组白细胞、D-二聚体高于对照组,血红蛋白、血小板、纤维蛋白原低于对照组,观察组尿蛋白水平高于对照组,差异均有统计学意义(P<0.05),观察组出生低体重、新生儿窒息或死亡、子宫胎盘卒中、产后出血均高于对照组(P<0.05)。观察组中入院即诊断胎盘早剥者较入院后发现者早剥面积大、新生儿评分低、产后出血多,差异有统计学意义(P<0.05)。结论:早发型重度子痫前期患者较易发生胎盘早剥,重视胎盘早剥发生的早期临床表现,及时进行血常规、凝血功能、尿蛋白水平及B超检测,及时发现、早期处理胎盘早剥以改善母儿预后。

Clinical analysis of 46 cases with abruptio placentae complicated by severe pre-eclampsia

Objective:To explore clinical features and maternal and fetal outcome of abruptio placentae complicated by severe pre-eclampsia.Methods:Cases(n=46) were defined as women with abruptio placentae complicated by severe pre-eclampsia.Controls(n=383) were selected from women with severe preeclampsia of same period.The clinical feature and pregnancy outcome between cases and controls were compared.Results:Gestational weeks of cases(33.7±4.0) were earlier than those of controls(35.6±3.8),there was statistical significance(P<0.05).Antepartum hemorrhage,persistent uterine contraction,fetal distress and dead fetus in uterus of cases were higher than those of controls.WBC and D-dimeride of cases were higher,haemoglobin,platelet and profibrin were lower,Urine protein of cases were higher than those of controls,there were statistical significances(P<0.05).Abruptio placentae developed fetal distress and dead fetus,uteroplacental apoplexy were higher than controls.Postpartum hemorrhage of cases were more than controls(all P<0.05).Area of abruptio of patiens who were diagnosed abruptio placentae when admission were larger than those who were diagnosed abruptio placentae after admission,Apgar scores were lower and postpartum hemorrhage were more in patients who were diagnosed abruptio placentae when admission,there were statistical significances(P<0.05).Conclusion:The risks of abruptio placentae in patients with early severe pre-eclampsia are higher.We should pay attention to clinical manifestation of abruptio placentae and detect routine method,blood clotting function,urine protein and ultrasound in time.Detecting and treating abruptio placentae earlier may improve maternal and fetal outcomes.