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患者女,23岁。妊娠8个月初产妇。该患骑自行车与他人相撞后,第二天觉腹痛伴阴道少量流血入院。体检:T37℃,P90次/分,Bp80/60mmHg。神志清,精神萎糜,面色苍白,因腹痛呻吟不止,心肺听诊无明显异常。子宫呈强直收缩状态,胎位查不清,胎心听不到。内诊:阴道少量流血,宫口开大8cm,枕先露,胎胞已形成。入院诊断:孕8个月早产,胎盘早剥待除外。入院半小时后,自然娩出一男死婴(新生儿发育未见异常)。5分钟后胎盘自然娩出,见胎盘母体面近中央处有5×6cm的陈旧压痕。产后因阴道持续流血患者处于休克状态,经吸氧、肌注宫缩剂、静滴低分子右旋糖酐等抗休克治疗不见好
Female patient, 23 years old. 8 months pregnant primipara. The suffering bike collided with others, the next day with abdominal pain and a small amount of bloody hospitalization. Physical examination: T37 ℃, P90 times / min, Bp80 / 60mmHg. Consciousness, spiritual wilt, pale, groaning because of abdominal pain, cardiopulmonary auscultation no obvious abnormalities. Uterus was tonic contractions, fetal position check unclear, fetal heart can not hear. Internal consultation: a small amount of vaginal bleeding, cervix open large 8cm, pillow first exposed, fetal cells have been formed. Admission diagnosis: 8 months pregnant premature birth, except for placental abruption. Half an hour after admission, the natural delivery of a male infant baby (no abnormalities in neonatal development). 5 minutes after the natural delivery of the placenta, see the mother placenta near the center of a 5 × 6cm of the old indentation. Postpartum patients with persistent vaginal bleeding in shock, by oxygen, intramuscular uterine contractions, intravenous infusion of low molecular weight dextran and other anti-shock treatment is not good