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目的探讨胎盘早剥的诱发因素、临床特点、超声检查、分娩方式及母儿结局。方法选择北京第一中西医结合医院收治的胎盘早剥患者62例,回顾性分析患者的病例资料,寻找高危因素、临床表现、辅助检查、分娩方式和母婴并发症。结果高危因素中妊娠期高血压疾病22例、孕妇腹部受到外力撞击9例、胎膜早破4例、脐带因素2例、胎盘异常4例、孕产妇仰卧产程长12例、不明原因9例。临床表现以腹痛及阴道流血为主。B超检查为辅助诊断。母婴结局:孕产妇产后出现子宫胎盘卒中、产后出血等,无脏器损伤,经治疗均康复出院。新生儿早产14例、轻度窒息12例、重度窒息3例,胎死宫内1例。结论临床工作中应尽早发现胎盘早剥发生的高危因素,采取有效措施进行预防,尽早确诊并治疗可以改善母儿结局。
Objective To investigate the predisposing factors, clinical features, ultrasonography, mode of delivery and maternal and infant outcomes of placental abruption. Methods Sixty-two cases of placental abruption admitted to the First Integrative Medicine Hospital of Beijing were retrospectively analyzed. The risk factors, clinical manifestations, auxiliary examination, mode of delivery and maternal and infant complications were retrospectively analyzed. Results Among the risk factors, 22 cases of hypertensive disorders of pregnancy, 9 cases of external force impact on the abdomen of pregnant women, 4 cases of premature rupture of membranes, 2 cases of umbilical cord factors, 4 cases of placental abnormalities, 12 cases of maternal supine labor and 9 cases of unexplained causes. Clinical manifestations of abdominal pain and vaginal bleeding. B ultrasound examination for the diagnosis. Maternal and infant outcomes: maternal postpartum uterine placental stroke, postpartum hemorrhage, etc., no organ damage, after treatment were discharged. Neonatal preterm birth in 14 cases, 12 cases of mild asphyxia, severe asphyxia in 3 cases, 1 case of fetal death. Conclusions The high risk factors of placental abruption should be found as soon as possible in clinical work. Effective measures should be taken to prevent them. Early diagnosis and treatment can improve the outcome of the patients.