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患者31岁,孕4产1,以妊娠34周阴道出血20余天,流血加剧6小时,于1991年12日急诊入院。末次月经1990年5月3日,停经40天有轻微早孕反应,孕5个月感胎动,孕期检查无异常发现。于孕32周时始有无原因阴道出血,无腹疼,阴道出血渐增多如正常月经量3倍,曾经当地卫生室治疗无效而转我院。宫底脐上三横指,胎头在脐左侧,胎方位左肩前,胎心140次/分,耻上可闻及胎盘杂音。B超提示:横位中央性前置胎盘。立即输液、输血,在严密消毒下作内诊检查,宫口开大4cm全部为胎盘组织复盖。因系经产妇考虑宫口易扩张,故给予轻柔人工扩宫。扩至6cm,在全麻下宫口扩至近开全,作胎盘造孔术,然后行内倒转术,行足牵引术将胎体躯干娩出后,行穿颅术,相继将胎头娩出重约2200g,人工剥离胎盘,子宫收缩不良,应用宫缩
Patients 31 years old, 4 pregnant and 1 to 34 weeks of gestation vaginal bleeding for more than 20 days, bleeding aggravated 6 hours in 1991, emergency room admission. The last menstrual period May 3, 1990, menopause 40 days have a slight early pregnancy reaction, fetal mothers feel 5 months pregnant, pregnancy check no abnormal findings. At 32 weeks of pregnancy, there are no reasons for vaginal bleeding, no abdominal pain, vaginal bleeding increased as normal menstrual flow 3 times, once the local clinic invalid and transferred to our hospital. On the uterus at the end of the three horizontal cross refers to the fetal head in the left side of the umbilical, fetal left shoulder before the fetus, fetal heart rate 140 beats / min, shame on the smell and placental murmur. B-Tip: horizontal central placenta previa. Immediate infusion, blood transfusion, under strict disinfection for internal examination, open the mouth of the cervix 4cm for the placenta tissue cover. Maternity because of the Department of Maternity is easy to expand, so give a gentle artificial expansion. Expanded to 6cm, under the general anesthesia cervix to nearly open the whole, for placenta accreta, and then line inversion surgery, line foot traction after the carcass torso was delivered, the line through the skull surgery, one after another will be the first fetal breech delivery about 2200g Artificial stripping of the placenta, poor uterine contractions, the application of contractions