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妊娠合并完全性房室传导阻滞是一种罕见且严重的合并症。患者24岁,经产妇,3年前阴道正常分娩1胎,本次妊娠39周出现胎动减少,且近3天自觉不适,无阵痛,阴道无流液、流血。既往无心脏病史,无心动过速、咳嗽、发热、水肿、呼吸困难、端坐呼吸、夜间阵发性呼吸困难及胸痛病史。 体检:一般状况差,面色轻度苍白,无紫绀、水肿。脉率40次/min,血压14.7/8.0kPa(110/60mmHg),颈静脉无怒张,心肺系统检查未见异常。腹部检查可扪及单胎,头先露。子宫如妊娠32周大小,伴羊水过少,无宫缩,胎心140次/min。血红蛋白90g/L,尿常规及镜检正常。心电图提示完全性房室传导阻滞。超声证实羊水过少、宫内发育迟缓的诊断,胎儿生物物理检查正常,估计体重约2000g。
Pregnancy complicated with complete atrioventricular block is a rare and serious complication. Patients 24 years old, the maternal, vaginal birth 3 years ago, a normal childbirth, the 39 weeks of pregnancy decreased fetal movement, and almost three days conscious discomfort, no pain, vaginal fluid, bleeding. No past history of heart disease, no tachycardia, cough, fever, edema, dyspnea, sitting breathing, paroxysmal nocturnal dyspnea and chest pain history. Physical examination: poor general condition, pale looking pale, no cyanosis, edema. Pulse rate 40 beats / min, blood pressure 14.7 / 8.0kPa (110 / 60mmHg), no jugular vein engorgement, no abnormalities in cardiopulmonary system examination. Abdominal examination palpable single-child, first exposed head. Womb, such as the size of 32 weeks of pregnancy, with oligohydramnios, no contractions, fetal heart rate 140 beats / min. Hemoglobin 90g / L, urine and microscopic examination was normal. ECG prompts complete atrioventricular block. Ultrasound confirmed oligohydramnios, intrauterine growth retardation diagnosis, fetal biophysical examination was normal, estimated body weight of about 2000g.