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瘢痕子宫是指存在既往子宫手术史,并经过组织修复后形成瘢痕的子宫。瘢痕子宫再次妊娠分娩可能会发生子宫瘢痕处破裂,引发大出血,严重者危及产妇和婴儿生命。孟买血型是一种极为罕见的血型。本文报告了孟买血型瘢痕子宫妊娠分娩1例。患者6年前因头盆不称在外院行子宫下段剖宫产术,血型测定为孟买血型。诊断为瘢痕子宫。在本院行彩色多普勒超声(彩超)检查无明显头盆不称,胎儿宫内状况良好。考虑到瘢痕子宫阴道试产风险较大,在征得患者同意后,腰硬膜外联合阻滞麻醉下行子宫下段剖宫产术+双侧输卵管结扎术,手术顺利,未输血,新生儿娩出。孟买血型瘢痕子宫妊娠极其危险且不易处理,应加强术前备血准备工作,与检验科医师密切协作,制定严密的输血方案;尽量减少术中和术后出血。
Scar uterus refers to the existence of the history of previous uterine surgery, and after tissue repair the formation of scar uterus. Scar pregnancy uterine pregnancy may occur rupture of uterine scar, triggering major bleeding, serious endangering the lives of mothers and infants. Mumbai blood type is a very rare blood type. This article reports one case of pregnancy and childbirth in blood type scar in Mumbai. Six years ago, the patient did not have a cesarean section at the lower end of the uterus because of the cupping. The blood type was Mumbai blood type. Diagnosis of scarring of the uterus. In our hospital color Doppler ultrasound (color Doppler ultrasound examination) no obvious head basin is not known, the fetus is in good condition. Taking into account the greater risk of scarring uterus vaginal trial, with the consent of patients, the lower epidural anesthesia combined with lower uterine cesarean section + bilateral tubal ligation, the operation was successful, no blood transfusion, newborn delivery. Bombay blood type scar pregnancy is extremely dangerous and not easy to handle, should be prepared to enhance preoperative blood preparation, in close collaboration with the laboratory physicians to develop a rigorous transfusion program; to minimize intraoperative and postoperative bleeding.