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目的探讨妊娠期子宫及宫旁静脉破裂出血的诊断,治疗及孕妇、胎儿预后。方法回顾性分析台州市中心医院2001年1月至2012年8月收治的6例子宫及宫旁静脉破裂出血的诊治过程。结果 6例孕妇均以无明显诱因的剧烈腹痛症状就诊,超声检查腹腔中均见游离液体,其中3例见血肿形成,腹腔穿刺均抽出不凝血,均行开腹探查,1例中孕单胎行缝扎和明胶海绵填塞止血,保守治疗至足月后剖宫分娩,胎儿存活,4例晚孕单胎立即行剖宫产,胎儿存活,1例中孕双胎行剖宫产,胎儿死亡。结论超声提示腹腔积液,腹穿抽出不凝血并排除其他可能病因,术前可以做出子宫及宫旁静脉破裂出血的诊断,及时治疗能提高围产儿生存率。
Objective To investigate the diagnosis and treatment of ruptured uterine and paraventricular rupture during pregnancy and the prognosis of pregnant women and fetus. Methods Retrospective analysis of 6 cases of uterine and paraventricular rupture hemorrhage diagnosed and treated in Taizhou Central Hospital from January 2001 to August 2012 was retrospectively analyzed. Results All the 6 pregnant women were treated with the symptom of severe abdominal pain without obvious predisposition. The free liquid was seen in the abdominal cavity by ultrasound examination. The formation of hematoma was found in 3 cases. The blood was collected from the abdominal cavity without coagulation. Suture and gelatin sponge packing to stop bleeding, conservative treatment to full-term cesarean section after delivery, the fetus survived, 4 cases of singleton fetus immediately after cesarean delivery, fetal survival, 1 case of second trimester cesarean section, fetal death . Conclusion Ultrasound prompted ascites, abdomen perforation without coagulation and exclude other possible causes, preoperative uterine and paraventricular rupture can make a diagnosis of bleeding, timely treatment can improve perinatal survival rate.