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女患,35岁,住院号124363。初孕36周。于1987年4月27日晨起突感腹部持续性胀痛,活动后加重,无阴道流血及排液。接生员以双手推揉子宫后,腹部疼痛加剧,并感头昏眼花而昏倒。入院时体温35℃,脉博110次/分,血压70/40mmHg。重度贫血貌,神清,全腹压痛、反跳痛,腹肌紧张。宫底,胎心、胎位均不清。无阴道流血,宫口未开,产道无异常。初诊为:①隐性出血型胎盘早剥。②失血性休克。急查纤维蛋白原,凝血酶原时间,三P试验均正常。血红蛋白4g/L。
Female patient, 35 years old, hospital number 124363. 36 weeks of first pregnancy. In the morning of April 27, 1987 suddenly sensation abdomen continuous pain, aggravating after activity, no vaginal bleeding and drainage. The midwife pushed the uterus with both hands, abdominal pain intensified, and feeling dizzy and collapsed. Body temperature at admission 35 ℃, Pulse Bo 110 times / min, blood pressure 70 / 40mmHg. Severe anemia appearance, God clear, full abdominal tenderness, rebound tenderness, abdominal muscle tension. Palace bottom, fetal heart rate, fetal position are unclear. No vaginal bleeding, cervix is not open, no abnormal birth canal. First diagnosed as: ① hidden hemorrhage placental abruption. ② hemorrhagic shock. Urgent check fibrinogen, prothrombin time, three P test were normal. Hemoglobin 4g / L.