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女婴,4天,第一胎足月自然分娩,出生体重2,800克,母产前骨盆测量骶耻外径、髂前上棘等4个指标均在正常高值。患儿出生时情况良好,生后48小时发现面色逐渐苍白,腹部膨隆,哭声低,反应差,吸吮无力。第4天检查,患儿精神萎糜,皮肤苍白,巩膜轻度黄染,心率164/次/分,呼吸54次/分,脉搏细弱尚能扪清,腹部膨隆肌卫不明显,未扪及包块,肝肋下2cm,脾来触及,腹水征阳性。大便呈深黄色。当时考虑有内脏出血及新生儿溶血症的可能。实验室检查:血红蛋白5.1克%,红细胞216万/立方毫米,网织细胞1.5%;母女血Rh 因子均为阳性;患
Baby girl, 4 days, the first full-term natural childbirth, birth weight 2,800 grams, pelvic hypothalamic measurement of sacral external diameter, anterior superior iliac spine and other four indicators are in normal high values. Children born in good condition, 48 hours after birth, pale gradually found, bulging belly, crying low, poor response, weak sucking. Day 4 examination, children wilting spirit, pale skin, scleral mild yellow dye, heart rate 164 / time / min, breathing 54 beats / min, pulse weakness still palpable, abdomen muscle bulge is not obvious, not palpable Mass, liver ribs 2cm, spleen to touch, signs of positive ascites. Dark yellow stool. At that time consider the possibility of visceral bleeding and neonatal hemolytic disease. Laboratory tests: hemoglobin 5.1 g%, red blood cells 2.16 million / cubic mm, reticular cells 1.5%; maternal and female blood Rh factors are positive;