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目的:分析隐性胎盘早剥漏诊、误诊原因,提高早期诊断率,降低母婴并发症。方法:回顾性分析我院2009年1月~2013年1月期间隐性胎盘早剥的23例临床资料,统计发病时间、产前有无胎心异常、血检异常、B超情况,宫缩情况,寻找其发生发展的共性与特殊性。结果:我院隐性盘早剥发生率为0.29%。其中出现产前凝血功能障碍3例,宫缩频繁但宫口扩张缓慢或伴胎心异常14例,单纯胎心异常4例,2例无任何症状。子宫卒中3例,产后大出血1例,子宫次全切除1例。新生儿转重症监护室3例。结论:临床中没有出现典型胎盘早剥表现,但出现凝血功能异常、宫缩频繁但伴宫口扩张缓慢、胎儿宫内窘迫时应高度警惕胎盘早剥的可能,并及时作相关的检查,及早诊断及处理,减少母儿不良结局的发生。
Objective: To analyze the causes of missed diagnosis and misdiagnosis of implicit placental abruption, improve the early diagnosis rate and reduce the complication of maternal and infant. Methods: The clinical data of 23 cases of tactile placental abruption in our hospital from January 2009 to January 2013 were analyzed retrospectively. The time of onset, prenatal absence of fetal heart rate abnormalities, abnormal blood tests, B-ultrasound, contractions Find out the commonness and particularity of its occurrence and development. Results: The incidence of recessive disc abortion in our hospital was 0.29%. There were 3 cases of prenatal coagulation disorders, frequent contractions but slow expansion of cervix or 14 cases of abnormal fetal heart rate, 4 cases of simple fetal heart failure, 2 cases without any symptoms. 3 cases of uterine stroke, 1 case of postpartum hemorrhage, subtotal hysterectomy in 1 case. Neonatal intensive care unit in 3 cases. Conclusion: There is no clinical manifestations of typical placental abruption, but there is abnormal coagulation, uterine contractions but accompanied by slow expansion of the cervix, fetal distress should be highly alert to the possibility of placental abruption, and make timely and relevant checks, as early as possible Diagnosis and treatment to reduce the occurrence of maternal and child adverse outcomes.