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孕妇,29岁。因妊娠29周,突感腹部持续性疼痛2h,于1997年12月6日上午入院。孕6产5,前5胎均为8月妊娠早产。既往体健,孕期无不适,无用药史。查体:T37℃,P120次/min,R20次/min,BP12/8kPa。疼痛病容,贫血貌。心肺无异常,腹部膨隆,下腹稍压痛。子宫增大如妊娠7~+月,头位,胎心120次/min。妇科检查:宫颈位置较高,宫口未开。诊断:①孕6产5 29周妊娠;②先兆早产;③妊娠合并贫血。给予静滴硫酸镁抑制宫缩,口服保胎、抗贫血药物。下午5时,患者腹痛难忍,持续性加重,面色苍白,痛苦表情,伴心悸、恶心、呕吐,全腹压痛,反跳痛。胎位、胎心不清,无阴道流血。化验:Hb67g/L,WBC8.4×10g/L,N
Pregnant woman, 29 years old. 29 weeks of pregnancy, sudden sensation of abdominal pain continued 2h, on December 6, 1997 morning admission. Pregnancy 6 5, the first 5 tires are premature pregnancy in August. Past physical health, no discomfort during pregnancy, no medication history. Physical examination: T37 ℃, P120 times / min, R20 times / min, BP12 / 8kPa. Pain and sickness, anemia appearance. No abnormal heart and lung, abdominal bulging, lower abdomen slightly tenderness. Uterus increased as pregnancy 7 ~ + months, the first position, fetal heart rate 120 times / min. Gynecological examination: higher cervical position, cervix is not open. Diagnosis: ① pregnant 6 5 29 weeks of pregnancy; ② threatened premature labor; ③ pregnancy complicated with anemia. Give intravenous magnesium sulfate inhibit contractions, oral miscarriage, anti-anemia drugs. 5 pm, the patient abdominal pain unbearable, persistent increase, pale, painful expression, with heart palpitations, nausea, vomiting, abdominal tenderness, rebound tenderness. Fetal position, fetal heart rate, no vaginal bleeding. Assay: Hb67g / L, WBC8.4 × 10g / L, N.