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患者,女,26岁。3年前顺产一女,健在。因孕38周于2001年8月19日入院待产。妇查:宫底高34cm,腹围绕72cm,胎儿头位。阴道壁光滑通畅,宫口未开,胎膜未破。B超提示单胎妊娠,胎盘附着于子宫左前壁。入院两天后顺产一男婴,胎儿娩出后20分钟胎盘娩出,胎盘及胎膜完整,阴道流血较少,未进行清宫。胎盘娩出后4小时,产妇阴道流血达900ml,妇查:软产道光滑无裂伤,侧切口无活动性出血。B超报告:子宫后壁增厚,有组织附着,内有强回声区。考虑为①凝血块,②附胎盘,③双胎妊娠的纸样胎。即行清宫:在了宫后壁触到一胎盘,部分与子宫壁粘连,剥离取出后见胎盘约4cm×5cm大小,胎盘及胎膜完整,剖开后可见一被压扁的死胎。清宫后阴道流血停止,子宫正常复位,一周后痊愈出院.
Patient, female, 26 years old. 3 years ago, a woman abortion, alive. Due to 38 weeks of pregnancy on August 19, 2001 admission to be produced. Women check: Palace at the end of 34cm high, abdominal circumference around 72cm, fetal head position. Smooth vaginal wall smooth, cervix is not open, the membranes are not broken. B-Tip singleton pregnancy, placenta attached to the left anterior wall of the uterus. Two days after admission, a single male baby was delivered, and the placenta was delivered 20 minutes after the baby was delivered. The placenta and fetal membranes were intact with less vaginal bleeding and no clearance. 4 hours after delivery of the placenta, maternal vaginal bleeding up to 900ml, women check: soft birth without smooth laceration, incision no active bleeding. B-report: thickening of the posterior wall of the uterus, with tissue attachment, there is a strong echo area. Considered as ① clot, ② with placenta, ③ twin pregnancy of the fetal pattern. That line Qing Palace: In the back wall of the palace touched a placenta, part of the adhesion with the uterine wall, stripped see the placenta after about 4cm × 5cm size, complete placenta and fetal membranes, cut open can be seen after a flattened stillbirth. Vaginal bleeding after the cessation of the palace, the uterus normal reset, a week after he was discharged.