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1 病历摘要例1,25岁,孕_1产_0,孕39~(+5)周。因头晕1周,反复抽搐5次,阴道出血4小时入院。查体:P92次/min,R23次/min,BP22/16KPa。宫高36cm,腹围95cm,宫底部压痛,头位,胎心160次/min,不规律宫缩,已破水,羊水Ⅱ°混,双下肢水肿(++),尿蛋白(++)。诊断:(1)孕_1产_0,孕39~(+5)周重度妊高征,子痫。(2)胎盘早剥。(3)胎儿宫内窘迫。经解痉降压治疗后,急行剖腹产术,娩出一活婴,Apgar1分钟3分。检查胎盘1/2面积早剥,胎盘后积血500ml,宫底及后壁呈紫色,提示子宫胎盘卒中。经按摩子宫及应用宫缩剂后宫缩好,保留子宫。母婴平安出院。
A summary of medical records 1,25 years old, pregnancy _1 _0, 39 (+5) weeks of pregnancy. Due to dizziness for 1 week, repeated convulsions 5 times, vaginal bleeding 4 hours admitted to hospital. Physical examination: P92 times / min, R23 times / min, BP22 / 16KPa. Palace height 36cm, abdominal circumference 95cm, Palace bottom tenderness, head position, fetal heart rate 160 beats / min, irregular contractions, has broken water, amniotic fluid Ⅱ ° mixed, double lower extremity edema (++), urinary protein (++). Diagnosis: (1) pregnant _1 production _0, pregnancy 39 ~ (+5) weeks of severe pregnancy-induced hypertension, eclampsia. (2) placental abruption. (3) fetal distress. After antispasmodic antihypertensive treatment, emergency cesarean section, delivered a living baby, Apgar 1 minute 3 minutes. Check the area of ?? 1/2 placental abruption, placental hemorrhage 500ml, purple at the bottom of the palace and the posterior wall, suggesting uterine placental stroke. After the uterus massage and application of uterine contractions hysterectomy, keep the uterus. Mother and child safely discharged.