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目的:提高胎盘早剥的早期诊断和及时治疗,降低母儿并发症。方法:回顾性分析我院2006年1月～2011年6月诊治的48例胎盘早剥的临床资料。结果:胎膜早破、妊娠期高血压疾病、胎儿生长受限为胎盘早剥的重要高危因素。主要临床表现为腹痛、子宫张力大、阴道流血、子宫压痛、胎心异常、死胎、血性羊水等。剖宫产30例,阴道产18例,产妇发生产后出血9例,DIC 2例,行次全子宫切除术1例,无孕产妇死亡。新生儿轻度窒息11例,重度窒息5例,死胎3例。结论:胎盘早剥病因多,临床表现个体差异大,及早识别和处理是降低风险,提高母婴结局的关键。
OBJECTIVE: To improve the early diagnosis and timely treatment of placental abruption and reduce the complications of mother and child. Methods: The clinical data of 48 cases of placental abruption treated in our hospital from January 2006 to June 2011 were retrospectively analyzed. Results: Premature rupture of membranes, hypertensive disorder complicating pregnancy, and fetal growth restriction are important risk factors of placental abruption. The main clinical manifestations of abdominal pain, uterine tension, vaginal bleeding, uterine tenderness, abnormal fetal heart, stillbirth, bloody amniotic fluid. 30 cases of cesarean section, 18 cases of vaginal delivery, postpartum hemorrhage occurred in 9 cases, 2 cases of DIC, subtotal hysterectomy in 1 case, no maternal deaths. Neonatal mild asphyxia in 11 cases, severe asphyxia in 5 cases, 3 cases of stillbirth. Conclusion: There are many causes of placental abruption, and individual differences in clinical manifestations are large. Early identification and treatment are the key to reduce risk and improve maternal and infant outcomes.