68例胎盘早剥的临床分析

目的探讨上海本地人口及流动人口胎盘早剥的高危因素以及对母婴的影响和预防。方法回顾分析该院近5年间胎盘早剥的发病情况、产前检查情况和母婴结局。结果在9 345例住院分娩产妇中,胎盘早剥68例(0.73%)。合并妊娠期高血压疾病(29例,42.65%)是胎盘早剥的首发病因,其次为胎膜早破、滥用催产素、脐带过短、血小板减少、外伤、双胎一胎娩出后一胎滞留宫内、羊水过多、妊娠期糖尿病及其他不明原因。患者进行产前检查>3次和1~3次者胎盘早剥的发生率明显低于无产前检查者;流动人口的胎盘早剥的发病率明显高于上海本地人口。结论预防是降低胎盘早剥发病率的关键,加强孕期宣教,提高流动人口的产前检查率;及早发现妊娠期并发症和合并症,积极治疗妊娠期高血压疾病;严厉打击非法接生;政府培育流动人口低收费的定点产科医院。

Clinical Analysis of 68 Cases with Placental Abruption

Objective To study the risk factors,outcomes and prevention of placental abruption.Methods Among the 9 345 deliveries between 2000 and 2004 in our hospital,68 cases with placental abruption were analyzed retrospectively on antenatal examinations and outcomes. Results Hypertensive disorder complicating pregnancy((42.65%)) was the most important predisposing cause,followed by premature rupture of membranes,oxytocin abuse,short umbilical cord,thrombocytopenia,trauma,polyhydramnios,gestational diabetes mellitus and undefined causes.The incidence of placental abruption was higher in floating populations than that in Shanghai locals. Conclusion(Prevention is) the key to reduce the incidence of placental abruption.Antenatal monitoring of floating populations,early discovery and proper handling of pregnancy-associated diseases and other methods are advised.