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患者女,26岁。第二胎,妊娠20周。妊娠早期无特殊,近一个月腹部增长快,活动受限,呼吸困难,不能平卧。既往身体健康。妊娠期间无放射线接触及病毒感染史,并否认近亲配偶。孕早期曾多次接触农药。入院检查:体温37.4℃,脉搏82次/分,血压130/90mmHg,轻度贫血貌,不能平卧,腹部膨隆,似双胎足月妊娠腹型,宫底剑突下一指,腹壁有广泛压痛,无反跳痛,胎儿肢体触不清,未闻及胎心。化验检查:血红蛋白9g。超声波提示羊水平段13.75cm,初步诊断为孕20周羊水过多症。入院后24小时,患者自然破水,羊水量约8,000ml左右,臀位娩出一女性死胎,从胎儿口腔脱出一巨大肿瘤(如图)。病理检查:
Female patient, 26 years old. The second child, 20 weeks of gestation. No special early pregnancy, abdomen nearly a month of rapid growth, limited mobility, breathing difficulties, can not lie down. In the past, good health. No history of radiation exposure and viral infection during pregnancy, and denied close relatives and spouses. Early pregnancy has repeatedly exposed to pesticides. Admission examination: body temperature 37.4 ℃, pulse 82 beats / min, blood pressure 130 / 90mmHg, mild anemia appearance, not supine, bulging abdomen, twins like full-term pregnancy abdomen, Tenderness, no rebound tenderness, fetal limbs palpable, unknown and fetal heart rate. Laboratory tests: hemoglobin 9g. Ultrasound prompted the sheep section 13.75cm, the initial diagnosis of polygated 20 weeks of pregnancy polycythemia. 24 hours after admission, the patient naturally broke the water, about 8,000ml of amniotic fluid, giving birth to a woman’s stillbirth in the buttocks and releasing a huge tumor from the fetal mouth (pictured). Pathological examination: