Clinical analysis of 23 cases of placental abrupti -

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Clinical analysis of 23 cases of placental abruption

Trauma history and so on. When there is no cause abnormal fetal heart rate is accompanied by production trillion, or labor; no reason for preterm birth; high uterine tone, even in the absence of vaginal bleeding, especially in slow fetal heart tones,[link widoczny dla zalogowanych], should take into account the disease. At the same time carefully observed contractions,[link widoczny dla zalogowanych], the palace high, facial expression changes, are invited to experience the B-doctor does not consider the fetus or in the case down cT check ... and improve the early diagnosis of placental abruption is not typical. 3.2B over the reliability of B-diagnosis non-invasive diagnosis of placental abruption fast. Has become an important adjunct of placental abruption diagnosis in 17 of 23 cases this routine B-mode ultrasound detection l3 cases, B-positive rate of diagnosis of 76.47%, but easy to missed small or posterior placenta placental hematoma . B-to clear the placenta due to plant parts, except for marginal placenta previa, antepartum hemorrhage caused by a small amount of help to the diagnosis of placental abruption. Therefore, l can not rule out placental abruption and clinical report of B-negative, to track the review, a conditional color Doppler ultrasound examination was feasible to observe the blood flow within the placenta echo _2J. To improve the early diagnosis of placental abruption. 3.3 The termination of pregnancy placental abruption most of the time and manner to be prompt termination of pregnancy, parturition of the fetus and placenta. Contraction of the uterus to stop bleeding. There are reports that l3j,[link widoczny dla zalogowanych], placental abruption once diagnosed, it should be timely termination of pregnancy, at the latest after the spin-off for 6 hours to complete. This one case PIH patients. After 2 days in the placental abruption hospital treatment, the patient body g, fetal death, uterine stroke, postpartum hemorrhage, DIC, intracranial hemorrhage, coma, a month after resumption of positive health life-saving treatment, but due to loss of fertility hysterectomy capacity. Therefore, the early termination of pregnancy, can reduce severe maternal complications. General choice of cesarean delivery placental abruption due to split the end of government-industry is a fast termination of pregnancy, effective measures to rescue the mother and the life. The following conditions should be immediately cesarean section: ① severe placental abruption. Short period of time can not end parturition; ② condition continued to deteriorate, even those within the official fetal death; ③ light placental abruption associated with fetal distress, fetal survival were generally good or light maternal placental abruption, estimated delivery in the short term end will be considered after vaginal delivery in the artificial rupture of membranes wrapped athletic abdomen, close observation of blood pressure, pulse, fundal height, vaginal bleeding and fetal heart rate changes, such as those found in fetal distress, cesarean section immediately. 3.4 Treatment of the complications of placental abruption ① coagulation disorders: Yi is the stripping plate early coagulopathy occurs during pregnancy most common cause. Early heavy plate surplus stripping, especially in cases of intrauterine fetal death is likely to occur coagulopathy. Contents of the uterus during pregnancy is a major source of procoagulant substances. If the patient is seriously ill, uterine contents are not clear,[link widoczny dla zalogowanych], or are not sure whether it has clear, positive antibodies in grams, to improve maternal respiratory and circulatory function, correct pH and electrolyte balance at the same time,[link widoczny dla zalogowanych], determined to take measures to terminate the pregnancy, or even a hysterectomy in order to block the promotion condensate material sources, the disease can quickly relieve l4. Treatment of shock transmission of new blood, if necessary, appropriate treatment such as heparin, are an important means to improve the cure rate. ② acute renal failure: severe placental abruption often caused by the severe pregnancy-induced hypertension. After the full complement of blood volume, such as urine output remains <17ml / h or no urine. 250ml 20% mannitol can be rapid intravenous infusion, or intravenous furosemide 40rag, if necessary, re-use by the general treatment is invalid, renal failure occurs, you should limit the liquid into the harmony, if necessary, for dialysis therapy in order to save maternal life. ③ postpartum hemorrhage: such as in critical condition, bleeding, patients have been active in the body should be added grams of blood volume status, correct shock and acid-base balance, try to lose new blood. Early use of contractions agent, and gently massage the uterus, but also intrauterine packing gauze, if still valid ascending uterine artery ligation can be supported. 3.5 hysterectomy necessary maternal and child health care during pregnancy affect the outcome of placental abruption is threatening the lives and health of mother and child emergency obstetric patients with placental abruption in this group of 23 patients were from rural areas. Awareness of poor perinatal care, and maternal and child health care during pregnancy directly affects the outcome. Strengthening prenatal care, reducing accidents happen. Reduce the incidence of pregnancy-induced hypertension can reduce the incidence of placental abruption and maternal and perinatal mortality.

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