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例1,22岁,因不规则阴道流血40~+d,量多16h,于1994年8月13日下午2h急诊入院。患者因“前置胎盘”剖宫产后半年,末次月经:1994年5月3日（古）,经量少,淋漓不净10余天;无腹痛,近1周感恶心呕吐纳差,1994年8月12日夜性生活时突然出现大量阴道流血;当地乡医院给止血治疗,出血量减少。次日7h阴道再次大出血伴头晕心慌,急诊入院。查体;T36.5℃ 、P88次/min,BP10/7kPa。重度贫血貌,心肺（一）,下腹部正中见一纵形疤痕,长约8cm。妇检:外阴畅,宫颈外口开2cm,颈管增粗饱满,宫体前位,增大如孕40~+d,与腹壁粘连,附件（阴性）。血HCG800ug/L,B超:子宫前位7.5cm×3.5cm,宫颈处探及2.5cm×2.0cm不均质团块,形态尚规则。拟不全流产。立即静滴低右,止血合剂,同时宫腔探查;扩张宫颈时突然出现大量出血,呈喷射状,患者迅速进入休克状。催产素治疗无效,即行宫颈填塞纱布2块,出血量减少,输血补液抢救休克,24h后在连硬麻做子宫切除准备下,取出阴道纱布,无活动性出血。宫颈管仍粗而饱满、软、宫深10cm,宫颈管内钳夹出机化胚胎组织约150g。宫颈注射催产素20~μ,颈管明显收缩窄。术后阴道出血渐止,并给抗感染止血治疗。刮出物送检报告为宫颈妊娠、术后12d血HCG降至正常。15d
Cases 1,22 years old, due to irregular vaginal bleeding 40 ~ + d, the amount of more than 16h, on August 13, 1994 at 2h emergency admission. Patients due to “placenta previa,” six months after cesarean section, the last menstrual period: May 3, 1994 (ancient), by the amount of less than 10 days dripping dripping; no abdominal pain, nausea and vomiting for nearly 1 week, anorexia, 1994 Abrupt vaginal bleeding occurred suddenly on the night of August 12; local township hospitals stopped the bleeding and the amount of bleeding was reduced. The next day 7h vaginal bleeding with dizziness palpitation, emergency admission. Physical examination; T36.5 ℃, P88 times / min, BP10 / 7kPa. Severe anemia appearance, cardiopulmonary (a), see a vertical scar in the lower abdomen, about 8cm long. Gynecological examination: smooth vagina, cervix and mouth open 2cm, thickening of the neck tube, the front of the Palace, such as pregnant 40 ~ + d, and abdominal adhesions, attachment (negative). Blood HCG800ug / L, B super: anteroposterior 7.5cm × 3.5cm, cervical exploration and 2.5cm × 2.0cm heterogeneous mass, the rules are still rules. To be incomplete abortion. Immediate intravenous infusion of low right, hemostatic mixture, at the same time uterine exploration; expansion of the cervix suddenly a large number of bleeding, was spray-like, the patient quickly into shock. Oxytocin treatment is invalid, that is, cervical gauze 2, reduce the amount of bleeding, transfusion resuscitation shock, 24h after hysterectomy with hard uterine preparation, remove the vaginal gauze, no active bleeding. Cervical tube is still thick and full, soft, deep palace 10cm, cervical clamp internalized embryo tissue about 150g. Cervical oxytocin injection 20 ~ μ, narrow neck constriction was narrow. Vaginal bleeding after surgery, and to anti-infection hemostasis. Reported scraping material for cervical pregnancy, after 12 days of blood HCG dropped to normal. 15d