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患者25岁,初孕38周于1987年7月30日临产入院。检查:P90次/分,Bp130/80mmHg,皮肤粘膜无出血点。宫底剑突下三指,胎方位ROA,胎头已入盆,胎心136次/分,肛诊宫口开大4cm。5小时后,胎膜破裂,宫口开全,宫缩强,产妇用力屏气。宫口开全1小时后,产妇头颈部突然出现许多瘀点。因胎心减慢至120次/分,即行会阴侧切,顺利娩出一女婴。婴儿重3400g,Apgar 评分10分。10分钟后,胎盘胎膜完整娩出。失血量约120ml。子宫收缩良好。产妇头面、颈部、肩部及胸背的上半部分有多数针尖或米粒大的瘀点,上述部位肤色紫暗。眼结膜、舌粘膜和口腔的两颊粘膜也见有出血点。而腹部、下肢及前臂却无出血点或瘀斑。血常规:RBC3×10~(12)/L,Hb85g/L,WBC9.3×10~3/L,N84%,L16%,PC110×10~9/L,
Patient 25 years old, 38 weeks of first trimester in July 30, 1987 admitted to hospital. Check: P90 beats / min, Bp130 / 80mmHg, skin and mucous membrane without bleeding point. Palace under the sword protruding three fingers, tire orientation ROA, fetal head has been into the basin, fetal heart rate 136 times / min, anal clinic cervix open large 4cm. 5 hours later, the rupture of the fetal membranes, cervix open all, contractions, maternal hard breath holding. 1 hour after opening the cervix, the mothers head and neck suddenly appeared many petechiae. Slow down to 120 beats / min because of fetal heart rate, that line will be episiotomy, smooth delivery of a baby girl. Baby weighing 3400g, Apgar score of 10 points. After 10 minutes, the placenta was completely delivered. Blood loss of about 120ml. Uterine contraction is good. The top half of the head, neck, shoulders and chest and back of the mother has a large number of petechia or peculiar petechia, and the above skin tone is dark purple. Eye conjunctiva, tongue mucosa and oral buccal mucosa also see a bleeding point. The abdomen, lower extremity and forearm but no bleeding spots or ecchymosis. Blood: RBC3 × 10 ~ (12) / L, Hb85g / L, WBC9.3 × 10 ~ 3 / L, N84%, L16%, PC110 × 10 ~ 9 / L,