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[病例]患者,28岁。三胎三产,产后24小时因下腹痛和阴道流血急诊入院。患者前二胎顺产,第三胎在家分娩,产程较第二胎长,约12小时娩出。产后半小时胎盘不下,出血较多,接生员多次推压子宫底,并用力牵拉脐带,取出胎盘,此时产妇突然感到下腹剧疼,出血仍多,给50％葡萄糖100毫升静脉注射,并肌注催产素一支后出血减少,但下腹痛加重而转院治疗。查体:患者表情痛苦,呈贫血貌,血压13/9kPa,脉搏98次/分,血红蛋白86.5g/L,白细胞16.8×10~9/L。双合诊在阴道内触到一软包块,超拳大,有压痛,此包块上方两侧有二
[Case] Patient, 28 years old. Three births, postpartum 24 hours due to lower abdominal pain and vaginal bleeding emergency admission. Patients with the second child before delivery, the third child at home birth, labor process than the second child, about 12 hours of delivery. Postpartum half an hour placenta, bleeding more, the midwifery press several times to push the uterus, and hard to pull the umbilical cord, remove the placenta, this time the mother suddenly felt a pain in the lower abdomen, bleeding is still more, to 50% glucose 100 ml intravenous injection, And intramuscular oxytocin bleeding after a decrease, but lower abdominal pain and transfer of treatment. Physical examination: patients with facial expression pain, anemic appearance, blood pressure 13 / 9kPa, pulse 98 beats / min, hemoglobin 86.5g / L, white blood cells 16.8 × 10 ~ 9 / L. Double Clinics touched a soft mass in the vagina, large boxing, tenderness, there are two sides above the mass