Clinical Analysis of 45 Cases of Maternal and Fetal Adverse Outcomes Caused by Delayed Diagnosis and Treatment of Placental Abruption

LIU Jing; LIU Xiao-wei

doi:10.3969/j.issn.1002-3429.2016.04.019

Abstract：Objective To analyze the cause of the missed diagnosis and misdiagnosis of placental abruption to im-prove maternal and fetal outcomes. Methods We performed a retrospective study on 45 women with adverse maternal and fe-tal outcome due to delay of diagnosis and treatment of placental abruption during January 2009 and December 2014. Results In this group, 20 cases (44. 4%) were irregular abdominal pain, 2 cases were diarrhea, 3 cases were vaginal bleeding. 13 cases (28. 9%) showed hypertension and the legs edema, 6 cases (13. 3%) were without any clinical manifestations, 5 cases (11. 1%) were fetal movement disappearing or reduced. Adverse maternal and fetal outcomes included severe neonatal as-phyxia (14 cases), diffuse intravascular coagulation (11 cases), stillbirth (10 cases), fetal death (9 cases) . There were predisposing factors, which accounted for 93. 3%(42/45). The causes of the missed diagnosis and misdiagnosis of placental abruption were uncoordinated contractions, atypical symptoms and signs, umbilical cord and placental factors and older preg-nant women. Conclusion The atypical clinical symptoms and the placenta attached to the rear wall is the main cause of delay in diagnosis and treatment. We should pay attention to the predisposing factors and quickly discover slight abnormal fetal heart rate in monitoring. With the help of laboratory tests, we should make diagnosis of atypical placental abruption and give treat-ment as soon as possible so as to improve maternal and fetal outcomes. We must judge women with adverse maternal and fetal outcome due to delayed diagnosis and treatment of placental abruption as early as possible for the purpose of better outcome.