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1、13例重度胎盘早剥临床分析曾素萍朱春霞江西省赣州市兴国县妇幼保健院妇产科摘要:目的探讨重度胎盘早剥的发病风险因素、早期识别诊断,管理以及评估孕产妇和母婴结局。方法对我院2012年1月一2016年12月来诊断13例重度胎盘早剥患者病情进行回顾性分析。结果最近5年在院分娩重度胎盘早剥发生率为0.092%o首位诱发因素重度子痫前期8例(61.54%),不明原因3例(23.08%),其它有脐带缠绕、外伤性因素、胎膜早破等因素。全部剖宫产终止妊娠;子宫胎盘卒中7例,凝血功能障碍5例,产后出血11例,积极正确处理后13例产妇
2、无一例死亡;新生儿7例,其中发生重度HIE并发颅内大量岀血在NICU死亡1例,流产或死胎6例。结论重度胎盘早剥致围产儿病死率高,产妇大出血率高,应引起临床医生高度重视,密切关注症状、胎心变化及产程进展,接诊医生思维应广阔,早期发现、早期诊断,及时正确干预,可提高围生儿和产妇预后。关键词:重度胎盘早剥;胎心监测;血凝四项;规律孕检;ClinicalAnalysisof13CasesofSeverePlacentalAbruptionZENGSupingZHUChunxiaDepartmentofObstetries
3、andGynecology,XingguoCountyMaternalandChildHea1thCareHospital;Abstract:ObjectiveToexploretheriskfactors,earlyidentificationandmanagementofsevereplacentalabruption,andtoevaluateandevaluatetheoutcomesofpregnantwomen,mothersandinfants.MethodsRetrospectiveanalysi
4、sof13casesofsevereplacentalabruptiondiagnosedinourhospitalfromJanuary2012toDecember2016.ResultsTheincidenceofsevereplacentalabruptioninthepast5yearsinhospitalwas0.092%.Thefirstpredisposingfactorswereseverepreeclampsiain8cases(61.54%),unknowncausesin3cases(23.
5、08%),otherfactorssuchasumbilicalcordentanglement,traumaticfactors,prematureruptureofmembranesandotherfactors.Allthecesareansection,7casesofuteroplacentalapoplexy,5casesofbloodcoagulationdysfunction,11casesofpostpartumhemorrhage,13casesofmaternalpositiveaftert
6、rcatmcnt,nooneofnconateildeath.7casesofncwborn,severeHIEcomplicatedwithintracranialhemorrhagein1caseofdeathinalargenumberofNICU,6casesofabortionorstillbirth.ConclusionSevereplacentalabruptioncausedbyperinatalmortality,maternalbleedingrateishigh,socliniciemssh
7、ouldpaymoreattentiontotheprogress,paycloseattentiontosymptoms,thefetalheartrateandbirthprocess,doctorsshouldbethinkingofthebroad,earlydetection,earlydiagnosisandtimelyinterventioncanimprovetheperinatalandmaternaloutcomes.Keyword:severeplacentalabruption;fetal
8、heartmonitoring;bloodcoagulationfourtest;regularpregnancytest;胎盘早剥是妊娠20周后正常位置胎盘发生部分或全部从子宫剥离,属于妊娠晚期严重并发症,发病急、发展快,若处理不及时可危及母儿生命UL总结分析我院近5年13例重度胎盘早剥病例,探讨重度胎盘早剥的发病风险因素、早期识别诊断,管理以及评估孕产妇和母儿结局,为