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女性,住院号:60992,孕1产0,孕38~(+4)周。以下腹阵发性坠胀4小时,见红3小时,行超声检查,既往无产科和妇科异常史,从未做过B超。彩超检查示:胎头光环完整,BPD:9.1厘米,脊柱排列整齐,胎心:148次/分,呈阵发性增快,可达290次/分,律齐。胎位+,(LOA)。FL:6.1厘米,胎盘位于宫底及后壁,光点粗,稍强,可见分隔小叶,未见明显钙化,羊水暗区2.8～3.0厘米,较局限,内见密集光点漂浮,脐带结构正常。脐动脉血流参数:RI:0.55,A/B:2.2,Vs:0.22m/s,V_D:0.1m/s。孕母子宫左侧腹腔内见大范围无回声暗区,上自左肋弓下,下达膀胱处,右邻子宫左宫旁,左达左侧腹,似无边界,无回声暗区内见纵横交错的网络状光带,光带粗细不匀,在0.3～1.0cm左右,类似胸水时的网络状声像图。子宫、胎儿被向孕妇右腹侧。超声诊断:1.单活胎(LOA),胎盘Ⅲ级;2.羊水少,羊水混浊;3.胎儿心率阵发性增快(心律失常);4.母体腹腔内异常回声:考虑:(1)腹腔积液(纤维素形成网络状改变),(2)不排除腹腔内巨大包块(探不到其边界的大包块)。
Female, hospital number: 60992, pregnancy 1 producing 0, pregnant 38 ~ (+4) weeks. The following abdominal paroxysmal bulge 4 hours, see red 3 hours, line ultrasound, past obstetrics and gynecological anomalies, never done B-ultrasound. Color ultrasonography showed: fetal head aura integrity, BPD: 9.1 cm, the spine arranged neatly, fetal heart: 148 beats / min, was paroxysmal increased up to 290 beats / min, law Qi. Fetal position +, (LOA). FL: 6.1 cm, the placenta is located at the end of the palace and the back wall, light spots thicker, slightly stronger, showing segmented leaflets, no significant calcification, amniotic fluid dark area of 2.8 to 3.0 cm, more confined, see dense light floating inside, umbilical cord structure is normal . Umbilical artery blood flow parameters: RI: 0.55, A / B: 2.2, Vs: 0.22 m / s, V_D: 0.1 m / s. Pregnant mother uterus, the left side of the abdominal cavity to see a wide range of echo-free dark area, since the left rib arch, issued by the bladder at the right next to the left uterine Palace, left up to the left abdomen, like no boundaries, no echo dark area see aspect Staggered network-like light band, light with uneven thickness, about 0.3 ~ 1.0cm, similar to the pleural fluid when the network-like sonography. Uterus, the fetus is to the pregnant woman right ventral. Ultrasound diagnosis: 1. Single-live birth (LOA), placenta grade; 2. Amniotic fluid less, cloudy amniotic fluid; 3. Fetal heart rate increased paroxysmal (arrhythmia); 4. Maternal abnormal abdominal echo: consider: (1 ) Peritoneal effusion (cellulose network formation changes), (2) do not rule out intraperitoneal huge mass (exploration can not find the border of the large mass).