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孕妇,30岁。孕1产0。因停经9月余,无诱因阴道大量流液1 h,于2012年11月入院。患者孕早期无感冒、发热、风疹等病史,无遗传病史,孕期无感染及服药史,孕期行唐氏筛查提示低危,(OGTT未见异常。产前急诊超声检查示:双顶径9.3 cm,胎儿大小与孕周相符,颅脑、颜面部、脊柱、四肢、双肺及腹腔内脏器未见明显异常,羊水指数12 cm。因胎膜早破,原发性宫缩乏力,第二产程胎头下降停滞行剖宫产。新生儿性别:女,胎龄39周~(+5),体质量3 580 g,身长49 cm,Apgar评分:1 min 10分,5 min 10分。术中见新生儿颜面部及周身大面积黑色素沉着,其上可见毛发生长,部分有破溃。实验室检查:血、尿常规、心电图均无异常发现。皮肤科检查:胸腹部及腰背部皮肤大面积黑色素沉着,呈黑色,有毛,其表面高低不平,粗糙肥厚,状似兽皮,触之质韧。另可见颜面部,四肢及臀部散在多发大小不等黑色斑片(图1~2)。临床诊断:先天性巨痣。
Pregnant woman, 30 years old. Pregnancy 1 production 0. Due to menopause more than 9 months, no incentive to vaginal fluid 1 h, admitted in November 2012. In the first trimester of pregnancy, there was no history of cold, fever, rubella, no history of inheritance, no history of infection and medication during pregnancy, and Down’s screening during pregnancy showed low risk (no abnormal OGTT). cm, fetal size consistent with gestational age, brain, facial, spine, limbs, lungs and abdominal organs no significant abnormalities, amniotic fluid index 12 cm. Due to premature rupture of membranes, primary uterine inertia, the second Neonatal gender: female, gestational age 39 weeks ~ (+5), body mass 3 580 g, body length 49 cm, Apgar score 1 min 10 min, 5 min 10 minutes. See newborn facial and whole body large area of melanoma, showing that hair growth, some ulceration. Laboratory tests: blood, urine, no abnormal ECG findings. Dermatology examination: the chest and abdomen and the lower back skin Area of melanin, black, hairy, uneven surface, rough and hypertrophy, shaped like a skins, toughening toughening.Other visible face, limbs and buttocks scattered in multiple sizes ranging from black patches (Figure 1 ~ 2) Clinical diagnosis: congenital giant nevus.