胎膜早破并发胎盘早剥7例的临床分析  

Premature Rupture of Membranes with Placental Abruption:Clinical Analysis of 7 Cases

作　　者：杨夫艳[1] 陆薇[1] 蔡艳萍[1] 

机构地区：[1]江苏省连云港市第一人民医院,222002

出　　处：《职业与健康》2009年第19期2116-2117,共2页Occupation and Health

摘　　要：目的探讨妊娠晚期胎膜早破并发胎盘早剥的发生率、早期诊断和处理要点。方法回顾分析2005年1月—2008年3月连云港第一人民医院产科分娩的胎膜早破病例,其中并发胎盘早剥者7例,与非胎膜早破发生胎盘早剥者进行比较,分析早期诊断和母婴结局。结果3年分娩总数4500例,胎膜早破并发胎盘早剥者占全部胎盘早剥的22.6%,胎膜早破是胎盘早剥的常见发病诱因,尤其是早产胎膜早破,胎膜早破并发胎盘早剥的发生率2.69%,而非胎膜早破者为0.57%,两者相比差异有统计学意义(P<0.01),血性羊水、胎心异常、阴道流血为其常见的临床表现。该研究中4500例孕产妇无一例死亡。结论胎膜早破是胎盘早剥的诱因之一,重视临床,并结合B超、胎心监护有助于早期诊断,以降低母婴并发症。[ Objective] To investigate the incidence, early diagnosis and treatments of placental abruption complicated with prema- ture rupture of membranes （PROM}. [ Methods] Patients with premature rupture of membranes （PROM } in Lianyungang First People＇s Hospital from January 2005 to March 2008 were analyzed retrospectively. Among which, 7 cases were complicated with placental abruption, compared with placental abruption patients without PROM. Early diagnosis and outcome of mother and fetus were analyzed. [ Results ] Totally 4500 delivery cases in 3 years were reviewed. In cases of placental abruption, 22.6% were complicated with PROM, and PROM was the most common inducement of placental abruption, especially for PROM in preterm premature, the incidence of PROM was 2.69% , that of patients without rupture of membranes was 0.57% , the difference was significant （ P 〈0.01 ）. Bloody amniotic fluid, abnormal fetal heart rate and vaginal bleeding were common clinical manifestations. No death case of pregnant woman was reported in this study. [ Conclusion] PROM is one of the inducements of placental abruption. Paying attention to inducements and clinical manifestations, assistant with ultrasound and fetal heart rate monitoring can be helpful in early diagnosis and reduction of maternal complications..

关 键 词：胎盘早剥 胎膜早破 诊断 

分 类 号：R714.4[医药卫生—妇产科学]