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初孕妇24岁,妊娠40~(+6)周,有不规则宫缩.于1991年4月29日上午6时入院.检查:胎位为左枕前,胎心140次/min,宫口未开.于上午12h45min突然破膜,阴边流出血性羊水约200ml,并有活动性出血,检查胎心80～100次/min,板样腹,考虑有胎盘早剥可能,立即给予吸氧大三联应用,同时进行剖宫产术前准备.于下午1h40min胎心消失,宫口1cm,即给头皮牵引、血止.于晚10h胎吸助娩一死婴,检查胎盘为帆状胎盘,胎盘上无凝血块及压迫,胎膜破口处有一大血管破裂.诊断:①G_1P_1孕40~(+6)W.②死产.③前置血管破裂.帆状胎盘,尤其是前置血管,临床上极为少见.国内报道:帆状胎盘在单胎中约占1/10左右,而前置血管又占帆状胎盘的1%.前置血管即是指帆状胎盘的血管接近宫颈口,而且位于胎先落之前时.因前置血管内为胎
The first 24-year-old pregnant women, pregnancy 40 ~ (+6) weeks, irregular contractions. On April 29, 1991 at 6 am admission. Check: fetal position for the left occipital, fetal heart rate 140 beats / min, cervix Open in the morning 12h45min sudden rupture of membranes, cloudy side bleeding hemorrhage amniotic fluid about 200ml, and active bleeding, check the fetal heart rate 80 to 100 beats / min, plate-like abdomen, consider the possibility of placental abruption immediately give oxygen triplex Application, at the same time for cesarean section preoperative preparation at 1h40min fetal heart disappear, cervix 1cm, that is, scalp traction, blood only in the late 10h fetus to give birth to a dead baby, check the placenta as a sail-like placenta, placenta Clot and oppression, there is a large rupture of the rupture of the fetal membrane diagnosis: ① G_1P_1 pregnant 40 ~ (+6) W. ② stillbirth.③ anterior rupture of the blood vessels.Plasty-like placenta, especially in front of the blood vessels, very clinical Rare. Domestic reports: sail-like placenta in singleton accounts for about 1/10 or so, while the pre-blood vessels accounted for 1% of the sail-like placenta .Prevented blood vessels refers to the sagittal placental vessels close to the cervix, and located in the fetal Before the first drop due to pre-vascular for the tire