目的:探讨与分析胎盘早剥合并胎死宫内的分娩方式。病例:患者女19岁,结婚5年,月经周期正常,15岁在家中曾早产一女婴,具体原因不详,家庭困难,第二次妊娠孕足月在外地医院分娩死胎死产,具体不祥,第三次家中早产一次,出生后死亡。现第四次怀孕,未检查过,孕晚期B超检查示足月于2013年5月5日中午11点3O分到我院因下腹阵痛2小时余就诊,发现病情危急,胎心慢,宫缩强,腹部张力高压痛明显,床旁B超提示孕35周胎盘早剥,羊水过多,胎盘与子宫肌壁间可见1.6cm低回声暗区,胎心慢,急诊抢救同时紧急手术,术中见羊水1500mL,羊水内无血液混杂,死胎取出一男婴。胎儿取出后胎盘随之彭出,积血块4OOmL,清除胎盘检查发现子宫为纵隔子宫,此次妊娠在右宫腔内,纵隔占子宫2分之一,马鞍形,子宫卒中前后壁占4分之一。手术顺利,失血1500mL。结果:经修整破裂口缘,逐层缝合子宫切口,手术当中输红细胞悬液4U,手术之后抗炎对症治疗之后,该患者5d后顺利出院。结论:要选择合适的时机以及正确的分娩方式来治疗胎盘早剥合并胎死宫内症状,这样可以对患者损伤降到最低化,其中值得肯定的分娩方式为阴道试产,其可以在严密地监测之下以及对凝血功能纠正的基础上经阴道分娩。 Objective: To explore and analyze the mode of delivery of placental abruption combined with fetal death. Case: The patient is 19 years old, married for 5 years, the menstrual cycle is normal, 15 years old at home had a baby girl premature, the specific reasons are unknown, family difficulties, the second pregnancy full term in the field hospital delivery of stillbirths, specific ominous, The third home premature birth once, died after birth. The fourth pregnancy, not checked, the third trimester of pregnancy B-scan showed full term on May 5, 2013 at 11: 30 in our hospital due to lower abdominal pain for more than 2 hours of treatment, found the critical condition, fetal heart rate slow, Palace Contraction, abdominal tension and high pressure pain significantly bedside B-tips placental abruption 35 weeks of pregnancy, polyhydramnios, placenta and the uterine muscle wall can be seen 1.6cm hypoechoic dark area, fetal heart rate slow, emergency treatment at the same time emergency surgery See amniotic fluid 1500mL, amniotic fluid without blood mixed, stillbirth remove a baby boy. After the removal of the fetus placenta followed by Peng, clot blood clots 4OOmL, clear the placenta examination found the uterus as the mediastinum uterus, the pregnancy in the right uterine cavity, mediastinal accounted for one second of the uterus, saddle-shaped, uterine stroke before and after the wall accounted for 4 points one. Smooth operation, blood loss 1500mL. Results: After the wounds were trimmed and ruptured, the uterine incision was stitched layer by layer. After the operation, 4U of red cell suspension was transfused and anti-inflammatory symptomatic treatment was performed after the operation. The patient was discharged after 5 days. Conclusion: To choose the right timing and the correct mode of delivery for the treatment of placental abruption combined with fetal death symptoms, thus minimizing patient damage, of which the mode of delivery is worthy of confirmation vaginal trial production, which can be strictly Surveillance as well as correction of coagulation based on vaginal delivery.