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患女,23岁。以停经8~+月、腹渐隆,伴阴道流水30min急诊入院。平素月经规律。LMP1997年10月10日(古),EDC1998年7月25日(古)。孕期经过顺利。10d前出现双下肢中度水肿,休息的缓解不明显,偶感头昏,30min前无明显诱因突然阴道大量流水,无腹痛。查体:T37℃,P90次/min,R21次/min,BP20/10kPa,发育正常,营养中等,心肺正常,腹膨隆,双下肢中度凹陷性水肿。产科检查:宫高30cm,腹围94cm,胎位COA,胎心不清。内诊为双阴道,脐带脱垂于右侧阴道,血管搏动感不明显,宫口松容2指。B超示:胎心慢、弱,胎儿存活。血常规:WBC7.2×10~9/L,Hb 106g/L,尿蛋白(+)。因还纳脐带失败,
Female, 23 years old. To menopause 8 ~ + month, abdomen, with vaginal flow 30min emergency admission. Regular menstruation. LMP October 10, 1997 (ancient), EDC July 25, 1998 (ancient). Pregnancy passed smoothly. 10d before the emergence of moderate lower extremity edema, rest ease was not obvious, even occasional dizziness, no obvious incentive 30min suddenly a large number of vaginal fluid, no abdominal pain. Physical examination: T37 ℃, P90 times / min, R21 times / min, BP20 / 10kPa, normal development, moderate nutrition, normal heart and lungs, abdominal bulging, moderate depression in both lower extremity edema. Obstetric examination: Palace height 30cm, abdominal circumference 94cm, fetal position COA, fetal heart rate is unclear. Internal consultation for the double vagina, umbilical cord prolapse in the right vagina, vascular pulsatile flu is not obvious, cervix loose 2 means. B ultrasound shows: Fetal slow, weak, fetal survival. Blood: WBC 7.2 × 10 ~ 9 / L, Hb 106g / L, urinary protein (+). Due to the failure to accept the umbilical cord,