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一、病例摘要患者33岁,孕5产1,主因“停经35周~(+3),宫颈环扎术后12周,发现宫颈管进行性缩短半天”于2014-06-09急诊收入院。患者自然流产3次。曾于2011-11-23停经28周~(+2)因重度子痫前期、围生期心肌病,心功能Ⅲ级入本院。入院第1天超声心动图结果显示:左室射血分数(LVEF)47%,左室舒张末期内径(LVED)5.9 cm,LVEDd/体表面积=2.98 cm/m~2均异常,左室壁运动弥漫性减弱,不吸氧状态下氧饱和度为93%~94%。入院后心慌、胸闷症状缓解。综合患者及胎儿情况,决定终止妊娠,患者坚决要求阴道分娩,在
First, the patient summary 33-year-old pregnant, 5 pregnant 1, mainly because of “menopause 35 weeks ~ (+3), cervical cerclage after 12 weeks and found that the cervix progressive shortened half a day” on 2014-06-09 Emergency Revenue hospital. Patients spontaneously aborted 3 times. Had 28 weeks in 2011-11-23 menopause ~ (+2) due to severe preeclampsia, perinatal cardiomyopathy, cardiac function Ⅲ grade into our hospital. Echocardiography on the first day of hospital admission showed that left ventricular ejection fraction (LVEF) was 47%, left ventricular end-diastolic diameter (LVED) was 5.9 cm, LVEDd / body surface area was 2.98 cm / Diffuse diffuse, non-oxygen state oxygen saturation of 93% to 94%. After admission, palpitation, chest tightness symptoms ease. Comprehensive patient and fetus situation, decided to terminate the pregnancy, the patient insisted vaginal delivery, at