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患者27岁,住院号12478。孕2产1,孕32~(+B)月,阴道流液1周,下腹阵发性疼痛18小时,于1986年11月25日11时入院。末次月经1986年4月11日。停经后2个月因患细菌性痢疾、滴虫性阴道炎曾口服四环素、灭滴灵,其它用药不详。妊娠期无明显早孕反应和胎动,自觉腹部较前次妊娠明显增大,活动后心悸、气短。2年前足月顺产一正常女婴,无流产史。查体:T37.5℃,P86次/分,R24次/分,Bp100/70mmHg。心肺正常,双下肢水肿(+)。腹部高度膨隆,尤以子宫底部宽大,腹围100cm。腹部扪诊胎位不清,未闻及胎心音。有规律宫缩,子宫壁软无压痛。阴道检查:阴道分泌物脓性、味臭,宫口开大5.5cm,宫颈水肿,胎膜已破,单臀先露S(-2),骶右前位,骨产道无异常。化验:Hb108g/L,RBC3.26
Patient 27 years old, hospital number 12478. Pregnancy 2 1, 32 ~ (+ B) month, vaginal fluid for 1 week, the lower abdomen paroxysmal pain 18 hours, at 11:00 on November 25, 1986 admitted. The last menstrual April 11, 1986. 2 months after menopause due to bacterial dysentery, trichomonas vaginitis had oral tetracycline, metronidazole, other medication unknown. No significant pregnancy reaction during pregnancy and fetal movement, consciously than the previous pregnancy significantly increased pregnancy, palpitations after activity, shortness of breath. 2 years ago, a full-term normal baby girl, abortion history. Physical examination: T37.5 ℃, P86 times / min, R24 times / min, Bp100 / 70mmHg. Cardiorespiratory normal, lower extremity edema (+). Abdominal height bulging, especially at the bottom of the uterus wide, abdominal circumference 100cm. Abdominal palpation of fetal position is unclear, did not smell and fetal heart sound. Regular contractions, soft uterine wall without tenderness. Vaginal examination: purulent vaginal discharge, smell stool, cervix large 5.5cm, cervical edema, fetal membranes have been broken, single hip first exposed S (-2), sacral right anterior, no abnormalities in the birth canal. Assay: Hb108g / L, RBC3.26