摘要
目的:探讨胎盘早剥患者保守治疗的临床价值,以改善母儿妊娠结局。方法:回顾性分析安徽省立医院近十年来诊治一般情况良好、无急性胎盘早剥征象且胎盘剥离面积<1/2的胎盘早剥患者60例的临床资料,其中行保守治疗32例(保守治疗组)和立即终止妊娠28例(未行保守治疗组),比较两组孕妇及新生儿情况以及胎盘剥离面积<1/3和介于1/3～1/2的两组孕妇的分娩方式及母婴结局。结果:①保守治疗组中仅1例患者出现胎死宫内(入院24小时),行剖宫产终止妊娠;其余孕龄平均延长3.1±0.6周。②保守治疗组孕妇剖宫产率、新生儿死亡率、新生儿Apgar评分≤3分、Apgar评分4～7分的比例均低于非保守治疗组(P<0.05);而保守治疗组阴道分娩率和Apgar评分≥8分的比例均高于非保守治疗组(P<0.05)。③两组在胎盘剥离面积<1/3和介于1/3～1/2时,新生儿Apgar评分和新生儿死亡率比较,差异均有统计学意义(P<0.05);胎盘剥离面积介于1/3～1/2时,两组分娩方式比较,差异也有统计学意义(P<0.05)。结论:对胎盘早剥症状较轻,胎盘剥离面积<1/2胎盘面积者,可行保守治疗,能延长孕周,减少早产儿并发症,提高早产儿存活率。对于胎盘剥离面积介于1/3～1/2的患者,保守治疗后孕妇和新生儿仍有较好的妊娠结局。
Objective：To evaluate the clinical value of conservative treatment of placental abruption to improve the pregnancy outcome. Methods： The clinical data of 60 cases with mild abruptio placenta from our hospital in recent ten years were retrospectively analyzed which had a good general conditions,no acute placental abruption symptom and with placental abruption aera not exceeding 1/2. Among whom,32 patients were treated in conservative way and the other 28 cases were dealed in non-conservative way. The delivery mode and outcome of mother and fetus were compared between these 2 groups（placental abruption aera 〈 1/3 ;1/3 - 1/2）. Results： ①Only 1 fetus died in intrauterine in conservative group （ within 24h after admission,then were bring out by cesarean delivery） ,all the other pregnant woman＇s gestational weeks were extended averagely 3. 1 ± 0.6 w. ②The cesarean section rate, proportion of Apgar ≤ 3, proportion of 4 ≤ Apgar≤7 in conservative group were alJ lower than that in non-conservative group（ P 〈 0. 05）. But the proportion of Apgar≥8 in conservative group was higher than that in non-conservative group（ P 〈0.05）. ③In placental abruption aera 〈 1/3 and in 1/3 ～ 1/2 conditions,there were significant difference in the Apgar scoring of neonate, and perinatal mortality between these 2 groups. When the placental abruption aera was among 1/ 3 ～ 1/2, there was significant difference in the delivery way between these 2 groups （ P 〈 0. 05）. Conclusions： Placental abruption patients with untypical symptom and stripping area 〈 1/2 could be treated in conservative way. The conservative treatment method have a positive effect in extending the gestational weeks, reducing the complication of premature and improving the survival rate of premature infant. For the patients whose placental abruption aera was in 1/3 ～ 1/2,conservative treatment can still result in good pregnancy outcome.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2013年第6期457-460,共4页
Journal of Practical Obstetrics and Gynecology
关键词
早产
胎盘早剥
保守治疗
胎盘剥离面积
Premature
Placental abruption
Conservative treatment
Placental abruption aera
