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患者26岁,第二胎足月妊娠分娩.临产后即出现持续性腹痛阵发性加剧,15小时后在家娩出一女死婴(脐绕颈两周).产后腹痛减轻,阴道出血约500毫升。产妇感头晕、心慌,遂于产后11小时入院。产前无外伤及阴道出血史.检查:T37.7℃,BP13.3/7.7KPa,面色苍白.心肺(一)。全腹压痛、反跳痛及移动性浊音(+)。子宫底平脐。宫腔探查无胎盘组织残留,子宫无破裂。腹腔穿刺抽出5ml 暗红色不凝血液。血常规:血红蛋白7.8g%,红细胞1.55×10~(12)/L,白细胞
The patient was 26 years of age with a second full-term pregnancy delivery, with persistent abdominal pain exacerbated after childbirth and a female infant birth (at around the neck for two weeks) after 15 hours Postpartum abdominal pain was relieved and vaginal bleeding was about 500 ml . Maternal feeling dizzy, palpitation, then admitted to postpartum 11 hours. Prenatal no history of trauma and vaginal bleeding. Examination: T37.7 ℃, BP13.3 / 7.7KPa, pale. Cardiopulmonary (A). Full abdominal tenderness, rebound tenderness and mobility dullness (+). Uterine flat navel. Uterine exploration without residual placental tissue, uterine rupture. Abdominal puncture took 5ml dark red non-condensable blood. Blood: 7.8g% hemoglobin, erythrocytes 1.55 × 10 ~ (12) / L, white blood cells