Li Yang, Tian Yuan, Liu Ning, Chen Yang, Wu Fuju
Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130041, China.
Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130041, China.
Taiwan J Obstet Gynecol. 2019 Mar;58(2):223-226. doi: 10.1016/j.tjog.2019.01.010.
This study aimed to explore the clinical characteristics and outcomes of placental abruption.
A total of 62 placental abruption cases were collected from the Second Hospital of Jilin University between January 2007 and December 2012. A retrospective study was conducted to explore the risk factors for placental abruption, clinical characteristics, and maternal and fetal outcomes.
Risk factors for placental abruption mainly include preeclampsia (39%) and premature rupture of membrane (10%). Abdominal pain (68%) and bleeding (35%) comprise the classical symptoms of placental abruption but the clinical picture varies from asymptomatic, in which the diagnosis is made by inspection of the placenta at delivery, to massive abruption leading to fetal death and severe maternal morbidity. Emergency cesarean section was performed in 45 cases (73%) of placental abruption. Sixty-two placental abruption cases were divided into 2 groups according to whether uteroplacental apoplexy occurred. The incidence of preeclampsia and the duration (time between on-set of clinical symptom and placenta delivery) in the observational group were significantly higher than that of the control group, showing statistical significance (P < 0.01).
The diagnosis of placental abruption should consider risk factors, symptoms, physical signs, dynamic ultrasound monitoring, and cardiac care. Early diagnosis and treatment can improve maternal and infant prognosis.
本研究旨在探讨胎盘早剥的临床特征及结局。
收集吉林大学第二医院2007年1月至2012年12月期间共62例胎盘早剥病例。进行回顾性研究以探讨胎盘早剥的危险因素、临床特征以及母婴结局。
胎盘早剥的危险因素主要包括子痫前期（39%）和胎膜早破（10%）。腹痛（68%）和出血（35%）是胎盘早剥的典型症状，但临床表现各异，从无症状（分娩时通过检查胎盘做出诊断）到导致胎儿死亡和严重母体并发症的大量早剥。45例（73%）胎盘早剥病例进行了急诊剖宫产。62例胎盘早剥病例根据是否发生子宫胎盘卒中分为2组。观察组子痫前期的发生率和病程（临床症状出现至胎盘娩出的时间）显著高于对照组，差异有统计学意义（P<0.01）。
胎盘早剥的诊断应综合考虑危险因素、症状、体征、动态超声监测及心脏监护。早期诊断和治疗可改善母婴预后。
