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目的阐述胎盘早剥的临床分析。方法分析在我院近4年发生的51例胎盘早剥的高危因素、临床表现,以期提高产前诊断率,改善母婴结局。结果发病诱因以胎膜早破、妊娠期高血压疾病、脐带绕颈、晚期流产或先兆早产保胎史占前4位。无明显诱因18例。Ⅱ、Ⅲ度胎盘早剥组下腹疼痛、子宫压痛伴子宫张力增高、胎心率异常的发生率明显高于Ⅰ度胎盘早剥组(P<0.05),但两组间阴道流血和血性羊水比较差异无统计学意义(P>0.05)。产前行超声检查15例,提示胎盘早剥8例(53.3%)。结论临床医师需重视胎盘早剥非外伤性的诱因,尤其对未足月胎膜早破引发的胎盘早剥问题不能不引起重视,早或中孕期有阴道出血者在孕晚期小心发生胎盘早剥。从多样化的临床表现中,结合B超提示及时诊断胎盘早剥。
Objective To explain the clinical analysis of placental abruption. Methods The risk factors and clinical manifestations of 51 cases of placental abruption occurred in the past four years in our hospital were analyzed in order to improve the prenatal diagnosis rate and improve the maternal and infant outcome. Results predisposing factors to premature rupture of membranes, hypertensive disorders during pregnancy, umbilical cord around the neck, late miscarriage or threatened premature delivery history of tetanus accounted for the top 4. No obvious incentive in 18 cases. The incidence of abdominal pain, uterine tenderness with increased uterine tension, and abnormal fetal heart rate in stage II and III placental abruption group were significantly higher than those in stage I placental abruption group (P <0.05). However, vaginal bleeding and bloody amniotic fluid The difference was not statistically significant (P> 0.05). Prenatal ultrasound examination in 15 cases, suggesting that 8 cases of placental abruption (53.3%). Conclusion Clinicians should pay attention to the causes of non-traumatic placental abruption, especially for premature rupture of membranes caused by placental abruption problems can not but pay attention, early or middle pregnancy with vaginal bleeding in the third trimester placenta accreta . From a variety of clinical manifestations, combined with B-prompt prompt diagnosis of placental abruption.