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| The cause analysis of missed diagnosis and misdiagnosis of 145 pregnant women with placental abruption |
| Foshan Maternal and Child Health Care Hospital, Guangdong Province, 528000 |
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Abstract Objective: To investigate clinical manifestations and auxiliary examination of women with placental abruption, and to analyze their clinical characteristics and causes of missed diagnosis and misdiagnosis. Methods： The data of 145 parturient with placental abruption were analyzed retrospectively and were divided into the group A (diagnosis correctly), group B (women with missed diagnosis), and group C (women with misdiagnosis) according to the final diagnosis results. The general information high-risk factors of placental abruption, clinical manifestations and auxiliary examination results of women in three groups were analyzed. Results: The proportion of the grade III of placental abruption of women in group A was the highest, the proportion of the grade I of placental abruption of women in group B was the highest, and the proportion of the grade II of placental abruption of women in group C was the highest. The proportion of trauma of women in group C was the highest, the proportion of hypertension during pregnancy was the lowest (P<0.05), but the proportions of trauma and hypertension had no significant difference between group A and C (P>0.05). There were no significant different in proportions of the women aged ≥35 years old, premature rupture of membranes, and polyhydramnios, and number of deliveries ≥3 times of women among the three groups (P>0.05). The rates of vaginal bleeding and abdominal pain of women in group B was significant lower than that of women in group A and C (P<0.05), but which had no difference between group A and C (P>0.05). The rates of uterine tenderness and bloody amniotic fluid of women in group A was significant higher than that of women in group B and C (P<0.05), but which had no difference between group B and C (P>0.05). There were no significant different in the rates of uterine contraction and fetal heart rate slowing down or disappearing among the three groups (P>0.05). The rate of abnormal ultrasonic examination of women in group B was significant higher than that of women in group A and C (P<0.001), but which had no difference between group A and C (P>0.05). There were no significant different in the rates of abnormal fetal heart monitoring, abnormal blood volume, and abnormal coagulation function of women among the three groups (P>0.05). Conclusion：The diagnosis of placental abruption based on trauma, vaginal bleeding, abdominal pain, or ultrasound results solely is easy to cause missed diagnosis or misdiagnosis, but uterine tenderness can be used as a reference index to reduce the missed diagnosis and misdiagnosis occurrence.
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