Clinical analysis of placental abruption

ZHOU Xiao-yi; SHI Cai-ying

doi:10.3969/j.issn.1674-3806.2013.09.13

Abstract：Objective To explore the predisposing causes and clinical manifestations of placental abruption (PA), analyze the causes of misdiagnosis and missed diagnosis of PA ,in order to improve the accuracy rate of early diagnosis of PA.Methods The clinical data of 29 cases of PA were retrospectively analyzed .Results The incidence rate of PA was 0.37%.Of them,the diagnosis of PA were confirmed in 18 cases prenantally(the comfirmed diagnosis group,accounting for 62.07%),PA were misdiagnosed or the diagnosis of PA were missed in 11 cases prenatally(the misdiagnosis and missed diagnosis group ,accounting for 37.93%).Mild PA were found in 19 cases,severe PA were found in 10 cases.The main predisposing factors included hypertensive disorders complicating pregnancy ,premature rupture of fetal membranes, traumatic factors and supine hypotensive syndrome .The clinical manifestations mainly in-cluded lumbar and abdominal distending pain , vaginal bleeding, bloody amniotic fluid,high uterine tension, fetal dis-tress, etc.The incidence rates of lumbar and abdominal distending pain , vaginal bleeding and high uterine tension in the comfirmed diagnosis group were higher than those in the misdiagnosis and missed diagnosis group (P<0.05).The detection rate of PA by B-ultrasound was 58.62%.Cesarean section were performed in 24 cases,vaginal delivery in 5 cases.Conclusion For lack of characteristic clinical manifestations , PA has a higher rate of misdiagnosis and missed diagnosis,so that it should be necessary to make a comprehensive analysis according to medical history , clinical symptoms and signs, B ultrasonic examination, and electronic fetal cardiac monitoring for timely and reasonable treat-ment, in order to reduce the incidence of complications of mother and infants .