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患者女,32岁,主因孕7个多月,二胎,阴道水13h,于2005年5月11日11:10入院。既往月经规律,1mp 2004年9月26日,EDC 2005年7月3日,于1998年放置宫内避孕环(母体乐)。查体:T 37℃,P 80次/min,R 20次/min,BP 110/60 mmHg,心肺听诊无异常。产检:宫高30 mm,腹围103 cm,胎位LOA,胎心140次/min,未触及不规律宫缩。肛查:未消失,宫口开大1cm,先露头 S~(-3),阴道口见水样液流出,未触及羊膜囊。彩超示:宫内孕,单活胎,头位,相当于孕30周,宫腔内避孕环(BPD 7.5cm,羊水3.6 cm,胎盘Ⅱ级,孕囊外子宫前下段内可探及避孕环回声)。血尿常规正常。初步诊断:①宫内孕30周,二胎,胎膜早破。②宫内节育器。给予预防感染及促胎肺成熟治疗。患者于2005年5月15日15:00开始规律宫缩3 h 后以 ROA 急
Female, 32 years old, mainly due to more than 7 months pregnant, second child, vaginal water 13h, at 11:10 on May 11, 2005 admitted. Previous menstrual regularity, 1mp September 26, 2004, EDC July 3, 2005, placed intrauterine device in 1998 (maternal music). Examination: T 37 ℃, P 80 times / min, R 20 times / min, BP 110/60 mmHg, cardiopulmonary auscultation no abnormalities. Inspection: Palace height 30 mm, abdominal circumference 103 cm, fetal position LOA, fetal heart rate 140 beats / min, did not touch the irregular contractions. Anal examination: did not disappear, cervix open 1cm, first outcrop S ~ (-3), see the vaginal orifice water sample flow out, did not reach the amniotic sac. Color ultrasound show: intrauterine pregnancy, single live births, head position, equivalent to 30 weeks of pregnancy, intrauterine device (BPD 7.5cm, amniotic fluid 3.6cm, placenta Ⅱ level, echo). Hematuria routine normal. Preliminary diagnosis: ① 30 weeks pregnant uterus, second child, premature rupture of membranes. ② IUD. Prevent infection and promote fetal lung maturation treatment. Patients at 15:00 on May 15, 2005 began contractions after 3 h regular ROA emergency