胎盘早剥英语

concealed bleeding or no bleeding
classic anemia
symptom
no abdominal pain no anemia
discrepancy bleeding / general uterine>gestation weeks uterine hardness likes board, tenderness, ，
1. Uteroplacental apoplexy Bleeding into the myometrium of the uterus giving a discolored appearance to the uterine surface. surface. (called Couvelair uterus, too库弗莱尔子宫) too库弗莱尔子宫 库弗莱尔子宫)
placental abruption
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Definition
At 20 weeks’ gestation later or delivery term, weeks’ whole or partial abruption have taken place before second stage of labor for placenta in normal position . It complicates 0 . 4 6 ∼ 2 . 1 % of all pregnancies. pregnancies. The perinatal mortality rate due to placental abruption is 20%-35% presently.
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Pathophysiology
2. Coagulation disorders Placenta abruption results from release of thromboplastin(促凝血酶原激酶 thromboplastin(促凝血酶原激酶) from the disrupted 促凝血酶原激酶) placenta and the subplacental decidua into the maternal circulation ,cause a consumptive coagulopathy（消耗性凝血病） coagulopathy（消耗性凝血病）.
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clinical manifestation
Ⅰ
area categories
< 1/3
Ⅱ
1/3 左右
Ⅲ
> 1/2
revealed
litter bleeding
concealed/revealed
sudden abdominal pain discrepancy of anemia/bleeding
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Etiology
1. Vascular disease
hypertensive disorders complicating pregnancy （preeclampsia子痫前期） preeclampsia子痫前期 子痫前期） hypertension nephrosis（肾病） nephrosis（肾病）
sign
uterine soft，no tenderness soft，
uterine/gestation weeks conformity fetus good postpartum check placenta
fundus rise， rise，
uterine>gestation weeks fetal heart tones disappear uterine contraction no intermission ,shock
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vein’s bed congestion or rupture
Etiology
5. The others : Cocaine abuse ,smoking ,etc.
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Pathophysiology
Basal pathophysiology ：basal decidua bleeding hematoma of posteroplacenta （ 胎 盘 后 血 肿 ） abruption adhesion place
tenderness, fetus alive uterine contraction is intermission
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auxiliary examination
1.Ultrasound： Ultrasound：
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1.
Ultrasound： Ultrasound：
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Treatment
treatment of postpartum hemorrhage: hemorrhage: strengthen uterine uterine; massage uterine; hysterectomy: subtotal hysterectomy: contraction,
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Etiology
2. mechanical factors trauma extreme shortness of umbilical cord （脐带过短） amniocentesis （羊膜穿刺术）
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Etiology
3. uterine volume suddenly narrow
according to :
Case history ,symptom ,sign and ultrasound, it can be diagnosis.
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Complication
1 DIC and
coagulation
disorders
2. Postpartum hemorrhage . 3. Acute kidney failure （急性肾功衰）. . 4 Amnionic fluid embolism ； amniotic fluid embolism .（羊水栓塞） 5. Fetal death .
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Etiology
4. Venous pressure of uterine suddenly heighten supine hypotensive syndrome（仰卧位 syndrome（ 低血压综合症） 低血压综合症） Venous pressure of decidua uterine suddenly heighten placental abruption
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Treatment
Termination of pregnancy: vaginal delivery: short time cesarean section: Ⅰ,in
Ⅱ distress（胎儿 窘迫） 窘迫） ;fetal death can not delivery by vaginal in short time.shock.
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Categories
1. Revealed abruption
Blood extend downward cervix,resulting in an hemorrhage. revealed hemorrhage. toward the external or
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Treatment
Therapeutic principle: principle: Countershock（抗休克） Countershock（抗休克） Prevention and cure DIC , acute kidney failure . Termination of pregnancy in time. time.
uterine cavity pressure drop fetal presentation descent quickly polyhydramnios （羊水过多） 羊水过多） rupture of membrane twins， twins，the first one labor rapidly
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auxiliary examination
2. laboratory examination
DIC examination Fibrinolysis confirmed diagnosis test （纤维蛋白溶解确诊 试验） 试验）
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Diagnosis
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Categories
3.mixed 3.mixed abruption
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clinical manifestation
Cardinal symptom ：sudden
abdominal pain and some vaginal bleeding .
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Categories
2.Concealed 2.Concealed abruption Blood may dissect upward toward the fundus ,resulting in an concealed hemorrhage.
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