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目的探讨不典型胎盘早剥临床特点,提高早期诊断率,改善母婴预后。方法对宜宾市第一人民医院收治的产前漏诊47例及产前确诊17例胎盘早剥临床资料进行回顾性分析。结果胎盘早剥发生率为0.36%,漏诊率为73.44%,胎膜早破及催产素使用不当是不典型胎盘早剥的主要发病诱因,胎心异常、早产及阴道流血是常见临床表现,胎盘早剥后剖宫产率、产后出血、胎窘率明显升高。结论不典型胎盘早剥发生率较高,病情隐匿,发病诱因不明确,症状不典型,轻型胎盘早剥及后壁胎盘早剥B超检出率低是漏诊的主要原因,应提高警惕,反复检查,动态观察,才能降低胎盘早剥发生率及母婴病死率,减少孕产妇死亡。
Objective To explore the clinical features of atypical placental abruption, improve the early diagnosis rate and improve the prognosis of maternal and infant. Methods A retrospective analysis was performed on 47 cases of prenatal missed diagnosis and 17 cases of prenatal diagnosis of placental abruption admitted to Yibin First People’s Hospital. Results The incidence of placental abruption was 0.36%, the rate of misdiagnosis was 73.44%. The premature rupture of membranes and the inappropriate use of oxytocin were the main causes of atypical placental abruption. Abnormal fetal heart rate, premature delivery and vaginal bleeding were common clinical manifestations. Placenta Cesarean section rate after abortion, postpartum hemorrhage, fetal distress rate was significantly increased. Conclusions The incidence of atypical placental abruption is high, the condition is hidden, the cause of the disease is not clear, the symptoms are not typical, and the low detection rate of the light placental abruption and posterior wall placental abruption is the main cause of missed diagnosis. It should be vigilant and repeated Check, dynamic observation, in order to reduce the incidence of placental abruption and maternal mortality, reduce maternal mortality.