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1 临床资料 1.1 患者33岁,于2000年7月20日以孕4产1孕41周、枕左前入院。查:纵产式腹型,宫高34cm,腹围101cm,头先露,枕左前,胎心140次/分钟,骨盆内外测量均在正常范围内,B超示双顶径9.7cm,股骨长7.5cm,估计体重3712g,前次顺产一体重为3650g女婴,血尿常规肝功无异常,行催产素引产。22日11时规律宫缩,17时50分宫口开全,此时虽静点1％催产素,但已出现宫缩乏力,助手帮助加腹压,考虑为经产妇软产道比较松弛未行会阴侧切。由于胎儿巨大,保护会阴不利导致会阴Ⅲ度裂伤,同时因宫缩乏力产后出血1000ml,新生儿评分7分,1分钟后10分,新生儿体重4700g,在无菌操作下行会阴Ⅲ度裂伤修补术,同时输血、补液、缩宫、抗炎治疗,10天后痊愈出院。
1 clinical data 1.1 patients 33 years old, on July 20, 2000 to pregnancy 4 weeks pregnant 41 weeks, left front occipital admission. Check: Abortion type abdomen, Palace height 34cm, abdominal circumference 101cm, the first first exposed, occipital left, fetal heart rate 140 beats / min, both inside and outside the pelvis measurements were within the normal range, B ultrasound showed biparietal diameter 9.7cm, femoral length 7.5cm, estimated body weight 3712g, the previous birth weight 3650g baby, no abnormalities in hematuria routine liver function, oxytocin abortion. At 11 o’clock on the 22nd law of contractions, at 17:50 cervix open, although this time static 1% oxytocin, but uterine inertia has emerged, the helper to help increase abdominal pressure, consider the maternal malaise more relaxed not Circumferential episiotomy. Due to the huge fetus, protecting perineal adverse lead to perineal third degree laceration, at the same time due to uterine bleeding postpartum hemorrhage 1000ml, neonatal score of 7 points, 1 minute after 10 points, newborn weight 4700g, under the atrophic operation of perineal third degree laceration Repair, while blood transfusion, rehydration, contraction Palace, anti-inflammatory treatment, cured 10 days after discharge.