A case of spontaneous uterine rupture in late preg

yxfbbiedtj · Wysłany: Pią 18:23, 25 Mar 2011

A case of spontaneous uterine rupture in late pregnancy

Secretions, the exposed parts of the first analogy ± Admission diagnosis: a second child died of a flail middle Yi 41 of pregnancy, placental abruption, uterine rupture. Treatment; correct shock. Placental abruption, fetal death into account, there uterus stroke, and uterine rupture, a greater risk of vaginal delivery, caesarean line exploratory surgery. Prepared to do a hysterectomy. See incomplete uterine rupture surgery, abdominal bleeding of about 150 ml, uterine to see stroke, lower uterine segment trench width ■ ● indeed. Amaterasu life leaves me shovel i snapped 2 cylinder s l2 t3 · wall subserosal of rupture, and extends to the right and right broad ligament of the pelvic ligaments have broken away from the funnel, cut the lower part of the serosal layer, along with the placenta discharge, Yi plate Pat-stripping, and see the blood clot about 20 ml, remove the ~ female stillbirth, uterine rupture at the edge of the irregular, necrotic, right off from the line of the pelvic ligaments funnel uterus resection. Discussion; no obvious incentive to late pregnancy induced hypertension, trauma, without surgery, the first child birth, hospital harem higher end of the uterus with pain and rebound tenderness, and listen to fetal heart tones are not heard. The diagnosis: cervical spine has commenced all children under the head, but no contraction of the uterus, placental abruption considered, but in the surgery that uterine rupture, uterine rupture more common reasons for delay in the fetal head, and a strong contraction of the uterus, pelvis , cephalopelvic disproportion,[link widoczny dla zalogowanych], malposition, pelvic tumor, followed by the more common abnormalities in the uterine muscle wall, such as uterine scar, congenital dysplasia, or abnormal uterus, oxytocin and operative delivery by improper use can cause uterine rupture injury. In this case do not have the above situation of maternal, uterine rupture because of abnormal uterine myometrium. Caused by maternal uterine rupture is rare. The side of the lower uterine segment uterine rupture in the anterior and posterior wall extending to the right side of the broad ligament subserosal and pelvic funnel ligament, uterine serosa is not broken, the blood can not enter the abdominal cavity, formed in the tie down ligament hematoma, anterior and posterior wall to the lower uterine segment , rupture of subserosal extension, the reason why the gap in the right uterine, uterus may be due to the mild, dextral heavier on the right side of the force. The cases of maternal lower abdominal pain intensified, but the breathing difficulties were taken to hospital, due to slow internal bleeding Court ligament, i woman I also feel shortness of breath, uterine tenderness all to the hospital after the operation in time to stop the bleeding, only to avoid cause very serious consequences. Future production should enhance prenatal acute observation, attention to blood pressure and pulse changes, alert the occurrence of bleeding. Prevention of infection, so as to early detection and early treatment of complications of acute capacity to ensure the safety of mother and child. A pre-eclampsia complicated by brain herniation foramen magnum case of Pu '7 t, 72. Iit Jiutai City Hospital, Taiwan Shu-hong Du Jing In City, Gui Ying Ji-bed home hospitals information Pro interpolation patients, female, 25 years old, Cambodia menstrual period April 21, 1991. Expected date of I990 on January 28, hospital No. 415, edema month, headache, seven days a heavier two days without any treatment, seizures four times, in la92 on Jan. 13 to Physical examination: blood pressure 22/14KPa, poor general condition, a high degree of edema, heart and lungs were normal. Uterine end of 36em, abdominal circumference lllem, children first semi-fixed, fetal heart rate l36 beats / min, no contractions, measured outside the normal pelvis, the cervix was not open. Blood to normal. Urine protein (-_L). The existence of physiological effects and pathological diagnosis of reflex was not elicited: l, a Yi, producing 37 weeks pregnant. LoA, 2, pre-eclampsia. Treatment: intramuscular injection of reserpine the second day. 2 grapes accelerate the feces 40rag 20ml glucose intravenously, I, half the amount of intramuscular injection of hibernation. 2O% mannitol 250 ml rapid static point. Within 5% glucose 500ml plus 20 sulfur - acid ~ 10ml of a static point. The next day blood pressure reduction NI8 / '12KPa increased urine output, swelling slightly reduced, the third day (January 16) 2l ~ 23/l4 blood pressure rose to a l7Kpa. In order to prevent disease progression in the afternoon local anesthesia by cesarean section in fetal surgery goes well, take out a normal boy, surgery patients are sleepiness, blood pressure 18, / I2KPa. Postpartum haemorrhage of about 40ml. To prevent bleeding, a large dose of contraction agents, blood pressure 20/I4KPa, rehydration 2000ml, with added 5.0 grams of nitrogen benzyl, vitamin c2.0g, lO units of oxytocin in the second day, intramuscular injection, the patient quiet operation sleep. January l7 found that mothers at the sleeping suddenly drawn to move several small limbs, pale blue, breathe deep and slow, snoring too for a few minutes after the double-suction, and then suddenly stop breathing. Clamp clamp tongue tongue immediately, and oxygen, intramuscular injection can pull undecided, Lobeline Fan 1. Then restore natural breathing, heart rate was 14o / min powerful, blood pressure z3/15