妊高征并发脑脐血管破裂致胎儿死亡一例太原市北城中心医院（０３０００２）董若玲患者女，２３岁。近预产期２天产科检查病理体征：Ｂｐ１９．５／１５ｋＰａ，尿蛋白（±）；超过预产期第５天，因血压高非急诊院，入院伴格检查除Ｂｐ２０／１５ｋＰａ外无其他明显异常，产科检查未发现异常，入院第二天２ｐｍ未闻及胎心，胎儿死亡半小时后Ｂ超提示：胎儿双顶径较６天前减少０．３ｃｍ，入院第三天在经引产娩出一死男婴，体重２．８ｋｇ，羊水Ⅲ°污染，胎儿粪染，颅骨较软，并重叠，脑实质较正常新生儿的脑实质明显软，整个脐带羊膜下积血，产后出血约６５０ｍｌ。讨论：此死胎从最后一次听到胎心至发现死亡为７小时，但死亡半小时Ｂ超提示：胎儿双顶径较６天前缩小０．３ｃｍ，说明胎儿脑组织在死亡前已有软化现象，故重度妊高征可致胎儿脑部小动脉痉挛，收缩时间过长，小动脉破裂致脑组织软化（表现为脑组织较软，颅骨重叠），重度妊高征致脐静脉痉摩，同样收缩时间过长，致脐静脉破裂（表现为羊膜下积血，胎儿死亡）。妊高征并发脑脐血管破裂致胎儿死亡一例@董若玲$太原市北城中心医院 Pregnancy-induced hypertension complicated by umbilical cord rupture caused by fetal death in a case of North City Central Hospital, Taiyuan (030002) Dongruiling patients female, 23 years old. On the 2nd day of the expected date of delivery, there was no obvious abnormalities except for Bp20 / 15kPa, due to the high blood pressure in the non-emergency hospital and admission examination, with Bp19.5 / 15kPa and urine protein (±) No abnormalities were found. On the second day after admission, 2-minute unreadable fetal heart rate and half an hour after fetal death showed that fetal biparietal diameter decreased by 0.3cm compared with 6 days before admission. On the third day after admission, a dead baby boy was delivered after induction of labor. 2.8kg, amniotic fluid Ⅲ ° pollution, fecal dysentery, skull soft and overlapping, brain parenchyma than the normal neonatal brain parenchyma, the entire umbilical cord amniotic hemorrhage, postpartum hemorrhage about 650ml. Discussion: The stillbirth from the last time I heard the fetal heart to death was found to be 7 hours, but half an hour of death B-Tip: fetal biparietal diameter less than 0.3cm 6 days ago, indicating that fetal brain tissue before the death of softening phenomenon , So severe pregnancy-induced hypertension can cause fetal cerebral artery spasm, contraction time is too long, arteriolar rupture caused by brain tissue softening (manifested as soft brain tissue, skull overlap), severe pregnancy induced hypertension induced vasospasm, the same Shrinkage time is too long, resulting in umbilical vein rupture (manifested as sub-hemorrhage, fetal death). PIH complicated by umbilical cord blood vessel rupture caused by a case of fetal death @ Dong Ruoling $ Taiyuan Beicheng Central Hospital