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胚胎移植术后妊娠合并葡萄胎1例

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摘要 1临床资料〈br〉 患者林某,住院号:00707360,37岁,1胎0产,末次月经:2012年3月01日,于2012年3月19日在沈阳某医院行胚胎移植术。停经3月余孕检时 B超提示:妊娠合并葡萄胎,未治疗。于孕6个月时出现阴道流血,少于月经量,暗红色,住院治疗1天,给予抑制宫缩及保胎治疗,血止。2012年8月03日查超声(如图1):宫内单胎,胎位:头位,胎心:142次/分,胎动:可及;BPD:5.4 cm,HC:20.0 cm,AC:17.3 cm,FL:3.9 cm;胎盘:右侧壁0级;羊水:AFI=19.0 cm,脐动脉 S/D:1.79。超声示:宫颈4.9 cm×4.1 cm,宫颈管分离0.6 cm。宫腔偏左侧见12.3 cm×7.8 cm 不均质稍强回声,%见多个大小不等囊腔,最大直径0.6 cm,双卵巢未显示,双附件区未及明显包块。超声提示:宫内单活胎,羊水偏多,合并葡萄胎?请结合临床。于2012年9月21日再次出现阴道流血,少于月经量,未治疗自行好转。入院前一天阴道流血增多,色暗红,于2012年09月25日入院。体温36.5℃,脉搏80次/分,呼吸17次/分,血压110/80 mmHg。胸部正位:双侧肺纹理增强。孕妇情况:宫高27 cm,腹围98 cm,胎方位:LOA,胎心音:144次/分,胎动可及,无宫缩。骨盆外测量:髂前上棘间径23 cm,髂棘间径25 cm,骶耻外径18 cm,坐骨结节间径8.5 cm,耻骨弓角度90度。骨盆内测量未测,内诊:宫颈管消失70%,宫口容受3 cm,胎膜未破。9月29日超声(如图2)回报:宫内单胎,胎位:头位,胎心:131次/分,胎动:可及。BPD:7.3 cm,FL:5.8 cm,HC:26 cm,AC:26cm。胎盘:后壁Ⅱ级,羊水:AFI:10 cm。脐动脉S/D:2.7。
出处 《中国实验诊断学》 2014年第4期673-674,共2页 Chinese Journal of Laboratory Diagnosis
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