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24岁,孕2产0,孕33周。因持续性下腹痛并阴道大出血4小时急症入院。孕期检查未见异常。体查:血压13.3/9.31kPa、脉搏120次,呼吸20次,面色苍白;腹大如足月妊娠,宫底剑突下2指,张力大,压痛,胎位不清,未闻胎心音。血红蛋白90g/L,血小板64×10~9/L,出凝血时间正常,纤维蛋白原1.4g/L。诊断:胎盘早剥DIC可疑、胎儿死亡。给静滴低右、氢化可的松及输血等,并行剖宫产术,术中发现胎盘早剥面1/3,宫底部有10cm×3cm及6cm×2.5cm卒中紫色块,后壁1/3范围有散在的紫蓝色斑块,宫缩不好,经多方治疗无效,出血越来越多而无凝血块,皮肤有散在血点,注射部出血难止,口吐血,血压听不到,复查血小板25×
24 years old, 2 pregnant with 0, 33 weeks pregnant. Due to persistent lower abdominal pain and vaginal bleeding 4 hours emergency admission. No abnormal pregnancy test. Physical examination: blood pressure 13.3 / 9.31kPa, pulse 120 times, breathing 20 times, pale; abdomen as full-term pregnancy, Palace of Swords 2 fingers below, tension, tenderness, fetal position unclear, unread fetal heart sound. Hemoglobin 90g / L, platelets 64 × 10 ~ 9 / L, the clotting time is normal, fibrinogen 1.4g / L. Diagnosis: DIC placental abruption suspicious, fetal death. To intravenous infusion of low right, hydrocortisone and blood transfusion, parallel cesarean section, intraoperative placental abruption surface 1/3, the bottom of the palace with 10cm × 3cm and 6cm × 2.5cm purple strokes of stroke, posterior wall 1 / 3 range of scattered purple blue plaque, uterine contractions is not good, the multi-treatment ineffective, bleeding more and without clotting, the skin has scattered blood points, the injection of bleeding is difficult to stop vomiting blood, blood pressure can not hear , Review platelets 25 ×