Analysis of Atypical Placental Abruption_West China Medical Journal

Authors：

ZHANG Yi ,  ZHOU Rong.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHOU Rong., Email: wawa_forever@163.com

Keywords：

不典型胎盘早剥; 诊断; 妊娠期并发症

DOI：

10.7507/1002-0179.20130497

Video：

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目的　探讨不典型胎盘早剥的临床特点。方法　对2008年5月－2009年5月收治的55例胎盘早剥患者的临床资料进行回顾性分析。其中产前漏诊30例，疑诊15例，确诊10例。胎盘早剥的产前确诊率为18.2%，漏诊率为54.5%。所有患者均经产后证实。结果　重度子痫前期（25.5%）、胎膜早破（12.7%）是胎盘早剥的主要发病诱因；阴道流血（52.7%）、腰腹痛（47.3%）及胎心异常（36.4%）是其常见的临床表现。胎盘早剥者，剖宫产率、胎儿窘迫及早产率均增加。结论　不典型胎盘早剥病情隐匿。后壁胎盘、早剥面积小及B型超声检查阴性是漏诊的主要原因。对此患者应提高认识，动态监测，及时处理，以改善母婴结局。

Citation： ZHANG Yi,ZHOU Rong.. Analysis of Atypical Placental Abruption. West China Medical Journal, 2013, 28(10): 1579-1581. doi: 10.7507/1002-0179.20130497 Copy

1.	Oyelese Y, Ananth CV. Placental abruption[J]. Obstet Gynecol, 2006, 108(4): 1005-1016.
2.	Tikkanen M, Nuutila M, Hiilesmaa V, et al. Clinical presentation and risk factors of placental abruption[J]. Acta Obstet Gynecol Scand, 2006, 85(6): 700-705.
3.	Ananth CV, Peedicayil A, Savitz DA. Effect of hypertensive diseases in pregnancy on birthweight, gestational duration, and small-for-gestational-age births[J]. Epidemiology, 1995, 6(4): 391-395.
4.	Ananth CV, Savitz D, Bowes WA, et al. Influence of hypertensive disorders and cigarette smoking on placental abruption and uterine bleeding during pregnancy[J]. Br J Obstet Gynaecol, 1997, 104(5): 572-578.
5.	Samadi AR, Mayberry RM. Maternal hypertension and spontaneous preterm births among black women[J]. Obstet Gynecol, 1998, 91(6): 899-904.
6.	Sheiner E, Shoham-Vardi I, Hallak M, et al. Placental abruption in term pregnancies: clinical significance and obstetric risk factors[J]. J Matern Fetal Neonatal Med, 2003, 13(1): 45-49.
7.	Kyrklund-Blomberg NB, Cnattingius S. Preterm birth and maternal smoking: risks related to gestational age and onset of delivery[J]. Am J Obstet Gynecol, 1998, 179(4): 1051-1055.
8.	Addis A, Moretti ME, Ahmed Syed F, et al. Fetal effects of cocaine: an updated meta-analysis[J]. Reprod Toxicol, 2001, 15(4): 341-369.
9.	Salihu HM, Lynch O, Alio AP, et al. Extreme obesity and risk of placental abruption[J]. Hum Reprod, 2009, 24(2): 438-444.
10.	Hung TH, Hsieh CC, Hsu JJ, et al. Risk factors for placental abruption in an Asian population[J]. Reprod Sci, 2007, 14(1): 59-65.
11.	Budde MP, De Lange TE, Dekker GA, et al. Risk factors for placental abruption in a socio-economically disadvantaged region[J]. J Matern Fetal Neonatal Med, 2007, 20(9): 687-693.
12.	Lindqvist PG, Happach C. Risk and risk estimation of placental abruption[J]. Eur J Obstet Gynecol Reprod Biol, 2006, 126(2): 160-164.
13.	Hossain R, Harris T, Lohsoonthorn V, et al. Risk of preterm delivery in relation to vaginal bleeding in early pregnancy[J]. Eur J Obstet Gynecol Reprod Biol, 2007, 135(2): 158-163.
14.	Weiss JL, Malone FD, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study[J]. Am J Obstet Gynecol, 2004, 190(3): 745-750.
15.	罗红, 罗晓琴, 李利珠, 等. 子宫后壁胎盘早剥的早期识别与预后分析[J]. 中国妇幼保健, 2007, 22(20): 2789-2791.
16.	Kikutani M, Ishihara K, Araki T. Value of ultrasonography in the diagnosis of placental abruption[J]. J Nippon Med Sch, 2003, 70(3): 227-233.
17.	王敏. 二维及彩色多普勒血流显像对胎盘早剥的诊断价值[J]. 中国超声医学杂志, 2001, 17(1): 67-69.
18.	Tikkanen M, Nuutila M, Hiilesmaa V, et al. Clinical presentation and risk factors of placental abruption[J]. Acta Obstet Gynecol Scand, 2006, 85(6): 700-705.

1. 　Oyelese Y, Ananth CV. Placental abruption[J]. Obstet Gynecol, 2006, 108(4): 1005-1016.
2. 　Tikkanen M, Nuutila M, Hiilesmaa V, et al. Clinical presentation and risk factors of placental abruption[J]. Acta Obstet Gynecol Scand, 2006, 85(6): 700-705.
3. 　Ananth CV, Peedicayil A, Savitz DA. Effect of hypertensive diseases in pregnancy on birthweight, gestational duration, and small-for-gestational-age births[J]. Epidemiology, 1995, 6(4): 391-395.
4. 　Ananth CV, Savitz D, Bowes WA, et al. Influence of hypertensive disorders and cigarette smoking on placental abruption and uterine bleeding during pregnancy[J]. Br J Obstet Gynaecol, 1997, 104(5): 572-578.
5. 　Samadi AR, Mayberry RM. Maternal hypertension and spontaneous preterm births among black women[J]. Obstet Gynecol, 1998, 91(6): 899-904.
6. 　Sheiner E, Shoham-Vardi I, Hallak M, et al. Placental abruption in term pregnancies: clinical significance and obstetric risk factors[J]. J Matern Fetal Neonatal Med, 2003, 13(1): 45-49.
7. 　Kyrklund-Blomberg NB, Cnattingius S. Preterm birth and maternal smoking: risks related to gestational age and onset of delivery[J]. Am J Obstet Gynecol, 1998, 179(4): 1051-1055.
8. 　Addis A, Moretti ME, Ahmed Syed F, et al. Fetal effects of cocaine: an updated meta-analysis[J]. Reprod Toxicol, 2001, 15(4): 341-369.
9. 　Salihu HM, Lynch O, Alio AP, et al. Extreme obesity and risk of placental abruption[J]. Hum Reprod, 2009, 24(2): 438-444.
10. 　Hung TH, Hsieh CC, Hsu JJ, et al. Risk factors for placental abruption in an Asian population[J]. Reprod Sci, 2007, 14(1): 59-65.
11. 　Budde MP, De Lange TE, Dekker GA, et al. Risk factors for placental abruption in a socio-economically disadvantaged region[J]. J Matern Fetal Neonatal Med, 2007, 20(9): 687-693.
12. 　Lindqvist PG, Happach C. Risk and risk estimation of placental abruption[J]. Eur J Obstet Gynecol Reprod Biol, 2006, 126(2): 160-164.
13. 　Hossain R, Harris T, Lohsoonthorn V, et al. Risk of preterm delivery in relation to vaginal bleeding in early pregnancy[J]. Eur J Obstet Gynecol Reprod Biol, 2007, 135(2): 158-163.
14. 　Weiss JL, Malone FD, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study[J]. Am J Obstet Gynecol, 2004, 190(3): 745-750.
15. 　罗红, 罗晓琴, 李利珠, 等. 子宫后壁胎盘早剥的早期识别与预后分析[J]. 中国妇幼保健, 2007, 22(20): 2789-2791.
16. 　Kikutani M, Ishihara K, Araki T. Value of ultrasonography in the diagnosis of placental abruption[J]. J Nippon Med Sch, 2003, 70(3): 227-233.
17. 　王敏. 二维及彩色多普勒血流显像对胎盘早剥的诊断价值[J]. 中国超声医学杂志, 2001, 17(1): 67-69.
18. 　Tikkanen M, Nuutila M, Hiilesmaa V, et al. Clinical presentation and risk factors of placental abruption[J]. Acta Obstet Gynecol Scand, 2006, 85(6): 700-705.

West China Medical Journal

Analysis of Atypical Placental Abruption

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