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患者25岁,初孕妊娠40周,于1995年2月11日入院。检查血压13/8kPa.宫高31cm,腹围86cm,胎方位为左枕前,胎心140次min.肛查:宫口开大1cm。骨盆外测量各径线均正常。入院2小时听不到胎心.B超提示:无胎心、在胎颈皮缘处见脐带漂浮.脐带反光增强,即刻引产,当宫口开大3cm时行人工破膜,羊水为Ⅲ度粪染,产程进展顺利,于当日18时自娩一女死婴,2800g,胎头娩出后发现脐带绕颈2周 紧,同时有一真结位于胎儿颈下,当时先断脐,血管钳穿过真结后脐带松解;检查脐带长90cm,细、变白、直径1cm呈扁平形,胶质薄,脐带扭转28周,距胎盘15cm处有一假结,32cm处有一真结。
Patient 25 years old, first trimester of pregnancy 40 weeks, on February 11, 1995 admission. Check blood pressure 13 / 8kPa. Palace height 31cm, abdominal circumference 86cm, fetal position for the left occipital, fetal heart rate 140 times. Anal examination: cervix open 1cm. Pelvic measurements of each diameter line were normal. 2 hours admitted to hospital fetal heart rate can not be heard. B-Tip: no fetal heart, see the umbilical cord at the edge of the fetal cord floating float enhanced umbilical cord induction immediately, when the cervix 3cm open artificial rupture of membranes, amniotic fluid III Fecal dystocia, labor progressing smoothly, on the same day at 18 o’clock a female childbirth, 2800g, fetal head was found around the neck after 2 weeks of tight cord, at the same time there is a real knot located in the fetal neck, when the first off the umbilical, forceps through The true umbilical cord after loosening; check the umbilical cord length 90cm, fine, white, diameter 1cm was flat, thin plastic, twisted umbilical cord for 28 weeks, 15cm away from the placenta has a fake knot, 32cm at a true knot.