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患者27岁,孕1产0,住院号33282.妊娠39周,顶产式,规律性宫缩6小时,于1986年8月26日入院.闭经40天始有轻度早孕反虚,孕4月觉胎动,孕期无阴道出血史.平素体健,月经正常,无腹痛及腹部疾患史.查体:T36.4℃,P100次/分,Bp16.0/10.7kPa,全身情况良好.宫底剑下三横指,头浮,胎心132次/分,宫口开大3cm,先露棘上3cm,已见红,未破膜。因头盆不称行子宫下段剖宫产术,娩出一正常女婴,重3600g.术中发现腹腔内有咖啡样液体约250ml.大网膜广泛性变色,呈黑褐色,并有多处约1×1cm 大小的溃烂面,粘附于宫壁,附件及周围器官.常规行大网膜剥离、大部切除和腹腔引流术.术后母婴均好.病理报告:坏死性大网膜组织.并可见较多含铁血黄素细胞.妊娠合并大网膜广泛性坏死罕见.因无明显的临床病症,术前诊断困难,故易误诊。若经阴道分娩,难以确诊,坏死组织不能及时清除,必将导致严重后果.
The patient was 27 years old, pregnant and 1 producing 0, hospital number 33282. 39 weeks of gestation, top-style, regular contractions for 6 hours, admitted to hospital on August 26, 1986. Amenorrhea since 40 days mild hypogynnia, pregnancy 4 Month of fetal movement, no history of vaginal bleeding during pregnancy. Plain body health, normal menstruation, no history of abdominal pain and abdominal disease. Physical examination: T36.4 ℃, P100 beats / min, Bp16.0 / 10.7kPa, the general condition is good. Under the sword three horizontal fingers, head floating, fetal heart rate 132 times / min, cervix open large 3cm, first exposed spines on 3cm, has seen red, not broken membrane. Due to the first basin of lower uterine cesarean section did not give birth, gave birth to a normal baby girl, weighing 3600g intraoperative intraperitoneal caffeine-like liquid about 250ml omental extensive discoloration, dark brown, and multiple 1 × 1cm size ulceration surface, adhesion to the uterine wall, appendages and surrounding organs .Others routine omentum stripping, most resection and abdominal drainage .Postoperative postpartum mother and child are good .Pathological report: necrotic omental tissue .And more hemosiderin cells can be seen in pregnancy associated with omental widespread necrosis rare because no obvious clinical symptoms, preoperative diagnosis is difficult, so easy to misdiagnosis. If vaginal delivery, difficult to diagnose, necrotic tissue can not be promptly removed, will lead to serious consequences.