Anlysis Of Matenral And Perinatal Outcome In Placental Abruption

Objective:Investigate the relationship with different degrees’ placental abruption and the pregnancyresult.Method:Collected101cases of placental abruption pregnant women’s and129cases of normalpregnant women without pathological pregnancy’s clinical data from June2008to June2013. According to the observation of postpartum placental coagulate blood pressure,divided them into3groups: I degree(small placental separation area); II degree(placentalseparation area is about1/3); III degree(placental separation area more then1/2).Analyzing the influence of morbidity, predisposing factors, clinical manifestation,diagnostic basis and process mode to the pregnant women and the fetus.Result:1. In recent years, as the morbidity of the pregnancy complications(gestationalhypertension, premature rupture of fetal membranes and placenta previa) increased, theincidence of placental abruption increased in five years from June2008to June2013,compared the incidence of placental abruption in5years, P=0.470, it had no statisticalsignificance.2. Compared the maternal and perinatal overall pregnancy result in theresearch group and the control group, in addition to the hysterectomy, the prenatal anemia,caesarean section, postpartum hemorrhage, DIC, uteroplacental apoplexy (P＜0.05) wereall statistical significant. The perinatal result, in addition to the neonatal death, the fetalweight, Apgar score, premature, stillborn foetus, transfer into the new pediatric(P＜0.05)were all statistical significant.3. Compared with the I grade, II grade and III grade’s resultof the placental abruption pregnant women and the perinatal infant, the pregnant woman’sincidence of anemia in prenatal and postnatal anemia were all high, the occurrence ratewere respectively26.73%and25.74%. Prenatal anemia differences comparison P<0.05，ithad statistical significance, different degree’s placental abruption pregnant women’s postpartum hemorrhage and maternal uterine apoplexy’s occurrence rate all had P<0.05, itwas statistically significant, the differences of different degree’s placental abruptionpregnant women’s cesarean delivery, DIC and uterectomy had no statistical significance.For the perinatal infant, three kinds of placental abruption’s stillbirth comparing P<0.05, itwas statistically significant,3different kinds of placental abruption’s perinatal pregnancyweight(＜2500g), Apgar score≤7point(1min), Apgar score≤7point(5min), prematureinfant, transfer into the neonatology department, no statistically significant in neonataldeath.4. Varying degrees’ placental abruption pregnant women’s difference of diagnosingtime was P=0.000, it had significant difference, different degree’s placental abruptionpregnant women’s general condition, delivery mode and the gestational age difference hadno statistical significance.5. Different degree’s placental abruption pregnant women’sinducing factors had no statistically significant difference.6. Different degree’s placentalabruption pregnant women’s comparing of the occurrence rate of bloody amniotic fluidP<0.05, it was statistically significant,3kinds of different degrees of placental abruptionpregnant women’s varying degrees of placental abruption’s stillbirth and different degree’splacental abruption’s B ultrasonography diagnose P=0.000, it had significant difference.7.Different degree’s placental abruption pregnant women’s varying degrees of placentalabruption’s comparing of the amount of postpartum bleeding P=0.000, it had significantdifference. It had no statistically significant difference in the clinical manifestations.8.Different degree’s placental abruption pregnant women’s varying degrees of placentalabruption’s method of treatment comparing: hot compress, massage, intramuscularhemabate injection P=0.000, it had significant difference, the rest comparing had nostatistical significance.Conclusion:1. In recent years, as the morbidity of the pregnancy complications(gestationalhypertension, premature rupture of fetal membranes and placenta previa) increase, themorbidity of the placental abruption increase, too.2. In the clinical work, as the degree of placental abruption and the vaginal bleedingamount are not in direct proportion, we should not judge the severity of placental abruption by the amount of vaginal bleeding; If we meet the situation of fetal intrauterine death, wemust be alert about if their are occurrence of the placental abruption, the more serious thedegree of placental abruption is, the greater the chance to fetal intrauterine death is; Oncewe find the bloody amniotic fluid, the possibility of placental abruption is greater, weshould pay attention to this.3. According to the principle of individualized treatment, the patients with smallgestational age, when in the condition of disease permitting, we can proceed the expectantmanagement， reduce the rate of preterm birth, increase the survival rate of the newborn.4. Under the fine condition of patients, if she can suffer vaginal delivery, we shouldchoose vaginal delivery, which can decrease the infection after cesarean section, deputyinjury and postoperative forming scarred uterus.5. The more serious the degree of placental abruption is, the occurrence rate of thecomplication with postpartum hemorrhage and uteroplacental apoplexy increase obviously,so in the diagnosis and treatment process, we should pay enough attention to the severeplacental abruption and should be well prepared.6. Ultrasound is the important checking method to diagnose placental abruption, and canprovide reference for the diagnose of placental abruption.7. We should establish and improve the3levels maternal and child health care system, andstrengthen the teaching to the pregnant women during pregnancy, improve their sense ofprotection, and attaches great importance to the pregnancy check, reduce the incentive ofplacental abruption from the source, at the same time, the doctors should standard thepregnancy test work for the pregnant woman, strengthen the supervision work duringstages of labor, improve the early recognition, diagnose in time, correct and rapidprocessing, so as to improve the results of the infant and mom.