Kozovski I, Bozova S, Patanov N, Protopopov F, Shopova P
Akush Ginekol (Sofiia). 1989;28(3):26-30.
Abruptio placentae was established in 202 pregnancies out of 43,678 pregnancies (0.48%). Pre-eclampsia was diagnosed in 76 women as well (37.6%). Caesarean section was performed in 109 women as vital maternal indications were found in 43 of them. 139 children were born alive (67.8%), but the perinatal mortality was 43.9% (90 children). The maternal mortality was 1.98% (4 women). Caesarean section should be made only in women with alive infant, but obligatory in all cases with severe separation, if preconditions for quick management of delivery by vaginal way lack. Vaginal delivery is recommended in all milder cases and dead fetus, but the duration of delivery should not surpass 6 hours. Total hysterectomy and tamponade of the operative field and vagina should be performed in women with persistent bleedings, but in grave cases a ligature of the hypogastric arteries as well. All interventions should be done after application of intensive infusion, transfusion and other reanimation. The authors propose a scheme for medicamentous treatment.
43678例妊娠中有202例发生胎盘早剥（0.48%）。76名女性被诊断为子痫前期（37.6%）。109名女性接受了剖宫产，其中43名存在危及生命的母体指征。139名婴儿存活（67.8%），但围产儿死亡率为43.9%（90例）。孕产妇死亡率为1.98%（4例）。剖宫产仅应在有存活胎儿的女性中进行，但如果缺乏经阴道快速分娩的条件，在所有严重胎盘早剥病例中均为必要。在所有较轻病例和死胎中建议经阴道分娩，但分娩时间不应超过6小时。对于持续出血的女性应进行全子宫切除术以及手术区域和阴道的填塞，但在严重病例中还应结扎腹下动脉。所有干预措施均应在进行强化输液、输血及其他复苏措施后进行。作者提出了药物治疗方案。
