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患者,女性,26岁.孕1产0,孕41周,腰酸下坠1小时,于1998年3月26日入院.患者平素月经规则7/30天.LMP:1997年6月11日.EDC:1998年3月18日.早孕反应轻,孕4~+月自觉胎动至今,孕7~+月出现双下肢浮肿,休息后减轻,未曾用药治疗.1小时前感腰酸下坠而入院.查体:T36.3℃,P 80次/分,R 17次/分,BP 26.67/17.33kPa,心肺无异常.产科检查:宫高35cm,腹围104cm,LOA,胎心140次/分,头定,浮肿(十十),尿蛋白(十).住院后予以解痉、镇静、利尿等治疗.次日出现不规律宫缩,胎心102～114次/分.内诊:宫口开大3cm,头,S~(-3),未及羊水囊,羊水Ⅲ度粪染.考虑胎儿宫内窘迫而行剖宫产术.手术顺利,剖一女婴,重2600g,右手六指畸形,Apgar评10分,胎盘16cm×16cm,钙化.脐带异常:①大体观:脐带距胎体30cm处分成二束枝,血管走行于胎膜与绒毛膜之间,每枝均由2条血管组成,充盈明显,二束枝相向而行,分别走行18cm、15cm后均呈扇形到达胎盘对侧.②局解后观:二束枝的内侧两血管融合为一,外侧两血管并行至胎体,且距交会处1cm有一长2cm、直径1mm的交通枝.脐带由一动脉、一静脉组成.
Patient, female, age 26. Pregnancy 1 birth 0, pregnant 41 weeks, backache 1 hour, was admitted to hospital on March 26, 1998. Patients usually menstrual rules 7/30 days LMP: June 11, 1997. EDC: March 18, 1998. Early pregnancy reaction light, pregnant 4 ~ + month fetal movement so far, pregnancy 7 ~ + appear lower extremity edema, rest after the reduction, no medication .1 hour before the feeling of backache falling and hospitalization. Physical examination: T36.3 ℃, P80 beats / min, R17 beats / min, BP26.67 / 17.33kPa, no abnormality of heart and lung.Obstetrical examination: Palace height 35cm, abdominal circumference 104cm, LOA, fetal heart rate 140 beats / Edema (ten), urinary protein (ten). After hospitalization to be antispasmodic, sedative, diuretic and other treatment. The next day there is irregular contractions, fetal heart rate of 102 to 114 beats / min. Head, S ~ (-3), less than the amniotic fluid sac, amniotic fluid III degree fecal dynasty.Consider fetal distress and cesarean section operation.A successful operation, a baby girl, weight 2600g, right hand six finger deformity, Apgar 10 Points, placenta 16cm × 16cm, calcification. Umbilical cord abnormalities: ① general view: umbilical cord from the carcass at 30cm into two branches, the blood vessels running in the fetal membrane and chorion between each branch by two blood vessels, filling significantly, Two branches sticking to the line, respectively, walk 18cm, 15cm were fan-shaped to reach the opposite side of the placenta. (2) After treatment, the viewpoints are as follows: The two blood vessels in the two bundles are fused into one, and the two blood vessels in the outer tube are parallel to the carcass. There is a traffic branch with a length of 2cm and a diameter of 1mm from the junction 1cm.