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患者,26岁,住院号72941,因引产术后6小时,剧烈腹痛2小时于1993年2月13日入院。该患因停经8个月,自觉胎动消失一天于2月10日到当地卫生院就诊,用胎心监护仪监测胎心音消失诊为“死胎”收入院治疗。入院后应用雌激素三天,于2月13日上午行羊膜腔内注入雷水引产。术中经过顺利。术后患者自觉腹部疼痛,疼痛呈持续性,近2小时疼痛加重,不能忍受,故急转入我院。入院后仔细询问病史,患者于胎动消失腹部坠痛,且恶心呕吐,呕吐物为胃内容物。卧床休息后,上述症状消失。入院查体:KT37.4℃、P80次/分、BP14/10Kpa急性痛苦面容,心肺未见异常,腹部膨隆,全腹肌紧张,有压痛及反跳痛,子宫底剑突下三指,胎心率未闻及,B超检查提示胎盘早剥,死胎。临床诊断,胎盘早剥,死胎。立即行剖腹探查术,术中见子宫后壁底部及部分前壁,约子宫体面积的4/5呈紫色,剖宫取胎后,见胎盘位于子宫底部,胎盘后有血肿,取出疑血
Patient, 26 years old, hospital number 72941, admitted to hospital on February 13, 1993 for 6 hours after induction of labor and 2 hours of severe abdominal pain. The affected menopause due to menopause 8 months, a day out of conscious fetal movement on February 10 to the local hospital for treatment, fetal heart rate monitor fetal heart sound disappeared as “stillbirth” income hospital treatment. Application of estrogen after admission for three days, on the morning of February 13 amniotic fluid injection of thunder water induction. Surgery passed smoothly. Postoperative patients consciously abdominal pain, pain was persistent, pain increased nearly 2 hours, can not stand, it is urgently transferred to our hospital. Carefully ask history after admission, the patient fell pain in the abortion of fetal movement, and nausea and vomiting, vomit for the stomach contents. After bed rest, the above symptoms disappear. Admission examination: KT37.4 ℃, P80 beats / min, BP14 / 10Kpa acute painful face, no abnormal heart and lungs, abdomen bulging, total abdominal muscle tension, tenderness and rebound tenderness, Heart rate did not smell, B-ultrasound revealed placental abruption, stillbirth. Clinical diagnosis, placental abruption, stillbirth. Immediate laparotomy surgery, see the uterine wall at the bottom and part of the anterior wall during surgery, about 4/5 of the uterine body area was purple, cesarean section fetus, see the placenta at the bottom of the uterus, placental hematoma, remove the suspected blood