Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), Hefei, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), Hefei, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, Anhui, China.
Placenta. 2021 Jan 1;103:220-225. doi: 10.1016/j.placenta.2020.10.006. Epub 2020 Oct 8.
To analyze the relationship between placental abruption severity and maternal pregnancy outcome and to explore the predictive value of pre-delivery laboratory test results for the severity of placental abruption.
The clinical datas of 126 patients with placental abruption diagnosed and treated in our hospital over the past 4 years were retrospectively analyzed. The severity of placental abruption was divided into degrees I to III. The pre-delivery laboratory results of all patients and data on maternal and fetal delivery outcomes were collected.
The analysis of maternal outcomes showed that the volumes of antepartum, intrapartum and postpartum hemorrhage and the rates of utero-placental apoplexy, uterine compression sutures and vascular embolization significantly increased with increasing placental abruption severity. Fetal delivery data revealed that 1- and 5-min Apgar scores decreased significantly with increasing placental abruption severity. Pre-delivery laboratory findings suggest that the white blood cell count, hemoglobin, hematocrit, platelet count, albumin, aspartate aminotransferase (AST), creatinine, prothrombin time (PT), prothrombin activity, prothrombin time - international standardization ratio (INR), D-dimer, fibrinogen (FIB), and fibrin degradation products (FDP) changed significantly with increasing placental abruption severity. Further analysis by Spearman and Pearson correlation found that the pre-delivery volume of antepartum hemorrhage, D-dimer, FDP and other indicators were correlated with placental abruption severity.
The harm of placental abruption to pregnant women and neonates increases with increasing abruption severity. Some laboratory test results can be predictors of placental abruption degree.
分析胎盘早剥严重程度与母婴妊娠结局的关系，探讨分娩前实验室检查结果对胎盘早剥严重程度的预测价值。
回顾性分析我院近 4 年来收治的 126 例胎盘早剥患者的临床资料，将胎盘早剥程度分为 I 度至 III 度，收集所有患者的分娩前实验室结果及母婴分娩结局数据。
母体结局分析显示，胎盘早剥严重程度越高，产前、产时和产后出血量及子宫卒中、子宫压迫缝合术和血管栓塞的发生率越高；胎儿分娩数据显示，胎盘早剥严重程度越高，1 分钟和 5 分钟 Apgar 评分越低。分娩前实验室检查发现，白细胞计数、血红蛋白、血细胞比容、血小板计数、白蛋白、天门冬氨酸氨基转移酶（AST）、肌酐、凝血酶原时间（PT）、凝血酶原活性、凝血酶原时间-国际标准化比值（INR）、D-二聚体、纤维蛋白原（FIB）和纤维蛋白降解产物（FDP）均随胎盘早剥严重程度的增加而显著变化。Spearman 和 Pearson 相关性分析进一步发现，产前出血量、D-二聚体、FDP 等指标与胎盘早剥严重程度呈正相关。
胎盘早剥对孕妇和新生儿的危害随胎盘早剥程度的增加而增加。一些实验室检查结果可以预测胎盘早剥的严重程度。
