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患者 23岁,孕_2产_0。停经26~+周于1995年9月12日入院。末次月经1995年3月11日,停经40天妊娠试验阳性,孕26周孕期检查B超发现羊水过少、胎儿畸形而入院。既往自然流产1次,身体健康。入院查体:血压14/10kPa,心肺末见异常。肝脾不大。腹部膨隆,宫高20cm,腹围89cm,胎心音140次/分。妇科检查:外阴、阴道无异常,宫颈光滑,宫体如妊娠26周大小。实验室检查:白细胞10×10~9/L,白红蛋白114g/L,血小板114×10~9/L,出、凝血时间正常范围。B超提示:单活胎、头位,羊水过少,仅于胎儿颈部探及一羊水平段0.5cm,其他部位未见羊水;胎儿畸形,四肢短、股骨长2cm,脊椎胸部以下缺如,胎儿肾、膀胱缺如,腹腔内有少量积液。入院后采用利凡诺胎膜外插管、催产素引产均未成功,1周后再次B超提示胎儿畸形如前,宫底部可探及羊水平段2.5cm,其他部位羊水平段0.5cm。B超导引下行利凡诺羊膜腔内注射引产术成功,25小时后自娩女性死胎,身长33cm,四肢短小,并指、马蹄足畸形,腰骶椎缺如,胎盘胎膜正常,
23-year-old patient, pregnancy _2 _0. Menopause 26 ~ + week on September 12, 1995 admission. The last menstrual March 11, 1995, menopause 40 days pregnancy test positive, 26 weeks pregnant during pregnancy B ultrasound found too little amniotic fluid, fetal malformation and admission. Previous natural abortion 1, good health. Admission examination: blood pressure 14 / 10kPa, abnormal heart and lung end. Small spleen and liver. Abdominal bulge, Palace height 20cm, abdominal circumference 89cm, fetal heart sound 140 times / min. Gynecological examination: vulva, vaginal anomalies, cervical smooth, as the size of 26 weeks pregnancy. Laboratory tests: white blood cells 10 × 10 ~ 9 / L, white blood protein 114g / L, platelets 114 × 10 ~ 9 / L, the clotting time normal range. B-Tip: single live tire, head position, oligohydramnios, only in the fetal neck exploration and a sheep horizontal section 0.5cm, no other parts of amniotic fluid; fetal malformations, short limbs, femur length 2cm, lack of chest below the spine , Fetal kidney, lack of bladder, a small amount of fluid within the abdominal cavity. After admission levofino fetal capillaries, oxytocin induction of labor were unsuccessful, and again after 1 week B-fetal abnormalities such as before, the bottom of the palace to explore and sheep horizontal section 2.5cm, other parts of the sheep horizontal section 0.5cm. B ultrasound guided downstream levofloxacin intramuscular injection induction of labor success, after 25 hours of female fetus from childbirth, body length 33cm, limbs short, and refers to the clubfoot deformity, lack of lumbosacral vertebrae, placental membranes normal,