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患者31岁,孕2产1。末次月经1997年8月15日,因停经9月、腹胀1天、阴道流液8h于1998年5月19日入院。患者于4年前曾行剖宫产获一男婴,产后10月婴儿因脑积水死亡。妇科检查:宫高28cm,腹围91cm,先露头,胎位左枕前位,胎心140次/min,律规则。已入盆,胎儿估计体重3100g。肛门检查:骨盆无明显异常,宫颈容受1OO％,宫口未开,胎膜已破,亢露平棘,羊水清。B型超声检查提示双顶径9.2cm,胎盘Ⅲ级,羊水暗区6.3cm。NST评分9分。体检:一般情况良好,心脏叩诊心界不扩大,听诊心串86次/min,心律齐,未闻及病理性杂音。两肺听诊呼吸音清,未闻受干湿性啰音肝脾触诊不满意。测T36.7℃,P86次/min,R20次/min,BP16/12kPa。两下肢浮肿(一)诊断:胎膜早破,疤痕子宫。
Patient 31 years old, 2 pregnancies. The last menstrual period August 15, 1997, due to menopause in September, bloating 1 day, vaginal fluid 8h on May 19, 1998 admission. Four years ago, the patient had a c-section with a baby boy who died of hydrocephalus in October. Gynecological examination: Palace height 28cm, abdominal circumference 91cm, first outcrop, fetal front left pillow, fetal heart 140 times / min, rules of law. Has been into the basin, the fetus estimated weight 3100g. Anal examination: no obvious pelvis abnormalities, the cervix by 1OO%, cervix is not open, the membranes have been broken, Kang Lu Pingchuan, amniotic fluid clear. B-mode ultrasound revealed biparietal diameter 9.2cm, placenta Ⅲ level, amniotic fluid dark area 6.3cm. NST score 9 points. Physical examination: the general condition is good, the heart percussion heart does not expand, auscultation heart string 86 times / min, rhythm Qi, did not smell and pathological murmur. Lung auscultation breath sounds clear, wet and dry rales did not feel palpation of liver and spleen not satisfied. T36.7 ℃, P86 times / min, R20 times / min, BP16 / 12kPa. Two lower limb edema (a) diagnosis: premature rupture of membranes, scar uterus.