Abstract: Objective To explore the causes of missed diagnosis and misdiagnosis in placental abruption, enhance the accuracy of early diagnosis, and reduce maternal and infant complications. Methods Clinical data about 153 cases with placental abruption were retrospectively analyzed from January 2011 to June 2016 in Haidian Maternal and Child Healthcare Hospital. Results The incidence of placental abruption was 0.33% (153/45 837). Of the 153 cases, abruption was graded as mild in 74 cases (48.4%), and severe in 79 cases (51.6%). Seventy-nine cases (51.6%) had predisposing factors, mainly including hypertensive disorders complicating pregnancy and premature rupture of membrane. The main clinical manifestations included lower abdomen pain, vaginal hemorrhage and bloody amniotic fluid. The detection rate of placental abruption by ultrasonography was 62.9%. Cesarean section was performed in 118 cases, while the other 35 cases had vaginal delivery. Eighteen cases developed uterine apoplexy, and 3 cases had disseminated intravascular coagulation. Fetal death occurred in 16 cases, stillbirth in 2 cases, neonatal asphyxia in 12 cases, and neonatal death in 1 case. Conclusion The clinical manifestations of placental abruption are easily confused with threatened labor, in labor or fetal distress.When placental abruption occurs in posterior wall placenta and dysplastic placenta, missed diagnosis might happen by ultrasound.