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患者徐××,25岁,孕1产0。主因孕8月,腹痛2天于2004年7月27日入院。既往月经规律。末次月经2003年12月6日,预产期2004年9月13日。孕期产检正常,2天前无明显诱因腹痛,阴道出血,B 超示宫内孕,单活胎头位,相当于孕34周。羊水极少,宫底囊性肿物(直径8.1cm),左卵巢肿物可能性大。查体:T 37.3℃,P 104次/分,R 20次/分,BP 130/80 mm-Hg,产检:宫高29 cm,腹围98 cm,可触及不规律宫缩,胎位 LOA,胎心104次/分,初诊:1.宫内孕34周一胎,LOA 先兆早产,2、羊水过少,3、妊娠合并左附件囊肿—蒂扭转?给予保胎,促胎肺成熟及抗生素预防感染治疗。患者体温高,腹痛无缓解,考虑是否有卵巢肿物蒂扭转可能,于7月28日行子宫下段剖宫产+腹腔探查术,术中见子宫下段形成差,有少量淡红色腹水,子宫
Xu × × patients, 25 years old, pregnant and a 0. The main reason for pregnancy in August, two days of abdominal pain in July 27, 2004 admission. Past menstrual rules. The last menstrual period December 6, 2003, the expected date of September 13, 2004. Prenatal examination during pregnancy, 2 days ago no obvious incentive for abdominal pain, vaginal bleeding, B ultrasound showed intrauterine pregnancy, single live fetus head, equivalent to 34 weeks of pregnancy. Very few amniotic fluid, cystic bottom of the cyst (diameter 8.1cm), the possibility of large ovarian tumor. Examination: T 37.3 ℃, P 104 beats / min, R 20 beats / min, BP 130/80 mm-Hg, inspection: Palace height 29 cm, abdominal circumference 98 cm, accessible to irregular contractions, fetal LOA, fetal Heart 104 times / min, newly diagnosed: 1. Intrauterine pregnancy 34 weeks a child, LOA threatened premature birth, 2, oligohydramnios, 3, pregnancy with left accessory cyst - pedicle torsion? Given miscarriage, fetal lung maturity and antibiotics to prevent infection treatment. Patients with high body temperature, abdominal pain without remission, to consider whether there is torsion of ovarian tumor may be, on July 28 underwent uterine cesarean section + abdominal exploration, intraoperative see lower uterine segment formation, a small amount of light red ascites, uterus