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患者女,37岁,汉族,主因第二胎孕35 5/7周多胎妊娠、浮肿半月加重伴胸闷、心悸5天于1993—5—1住院。患者末次月经92—7—25(农历),孕4个月胎动频繁,孕7个月B超发现宫内孕三胞胎。半月前开始双下肢水肿,逐渐波及全身,近5天不能平卧伴胸闷、心悸,一般活动受限,家族中无多胎史。查体:T37.1℃:P100次/分、R22次/分、BP24/14KPa、神清,喘息样呼吸,半卧位,全身高度浮肿,眼裂变窄,口唇发绀,两肺呼吸音粗糙,可闻及干性罗音,未闻及水泡音。心界无扩大,心率100次/分,心脏各瓣膜听诊区未闻及杂音。肝、脾未触及。腹部高度膨隆,宫高58cm、腹围127cm,无宫缩,三胞胎,先露一头二臀,未入盆,胎心分别142,130、136次/分。化验:血色素90g/l,尿蛋白(++++)。初诊:孕产孕35 5/7周
Female patient, 37 years old, Han nationality, mainly due to the second child pregnant 35 5/7 weeks of multiple pregnancy, edema aggravated with chest tightness, palpitations 5 days in 1993-5-1 hospitalization. Patients with the last menstrual 92-7-25 (Lunar New Year), 4 months pregnant frequent fetal movement, 7 months pregnant B ultrasound found intrauterine pregnancy triplets. Lower limb edema started half a month ago, and gradually spread to the body, nearly 5 days can not supine with chest tightness, palpitations, general activity is limited, no history of multiple births in the family. Examination: T37.1 ℃: P100 beats / min, R22 beats / min, BP24 / 14KPa, Shen Qing, wheezing breathing, semi-recumbent position, body edema, narrow eyes, narrow lips, lips, Can be heard and dry rales, no smell and blisters sound. No expansion of the heart, heart rate 100 beats / min, the heart of the valve auscultation area did not smell and noise. Liver, spleen not touched. Abdominal height bulge, Palace height 58cm, abdominal circumference 127cm, no contractions, triplets, first exposed a two hip, not into the basin, fetal heart rate respectively 142,130,136 beats / min. Assay: hemoglobin 90g / l, urinary protein (++++). First visit: Pregnancy 35 35/7 weeks