一、子宫颈妊娠误诊为难免流产 [病例摘要] 患者36岁,孕4产1,既往月经周期规律,现停经50天。停经44天时出现恶心、晨起呕吐等“早孕反应”。停经48天出现无原因阴道出血,量不多,曾按“先兆流产”治疗,未见显效,两天后出现间歇性较多量阴道出血,但无明显下腹痛,本人怕出血多,要求行人工流产术。术前检查发现宫颈明显增大、甚软、着色显著,子宫颈口通过一指松,子宫稍大稍软,阴道内有暗红粘稠分泌物。鉴于宫口已开,诊断为难免流产。按常规消毒后,用子宫探针测官腔为8厘米,当放入7号Hegar扩张器扩张子宫颈管时,突然出现多量无法控制的持续性出血,短时间出血量达800毫升,患者烦躁不安,出冷汗,打哈欠,脉搏120次/分、弱,血压70/40毫米汞柱,处于休克状态。在输液、输血的同时,立即填塞纱条压迫止血,并收入院。入院后迅即在硬膜外麻醉下 First, the misdiagnosed as miscarriage of cervical pregnancy miscarriage [Case Summary] Patients 36 years old, pregnant 4 1, past menstrual cycle, now menopause 50 days. Nausea occurred 44 days after menopause, early morning vomiting and other “early pregnancy reaction.” 48 days after menopause, no reason for vaginal bleeding, small amount, according to “threatened abortion” treatment, no markedly effective, two days later more intermittent vaginal bleeding, but no obvious lower abdominal pain, I am afraid of bleeding, requiring abortion Surgery. Cervical preoperative examination found significantly increased, very soft, significant coloring, the cervix through a loose fingers, the uterus slightly larger soft, vaginal secretions dark red. In view of the cervix has been opened, the diagnosis is inevitable abortion. After routine disinfection, uterine probe detection chamber for the 8 cm, when placed on the 7th Hegar dilator cervical dilatation, the sudden emergence of a large number of uncontrollable persistent bleeding, short-term bleeding amounted to 800 ml, the patient irritability , A cold sweat, yawn, pulse 120 beats / min, weak, blood pressure 70/40 mm Hg, in a state of shock. Infusion, blood transfusion at the same time, immediately stop packing gauze to stop bleeding, and income homes. Immediately after admission, epidural anesthesia