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多胎妊娠羊膜腔穿刺术后胎膜破裂及绒毛膜羊膜炎抗生素治疗后的成功结局

Successful outcome after antibiotic treatment of postamniocentesis membrane rupture and chorioamnionitis in multiple pregnancy.

作者信息

Ghidini A, Doria V, Kirn V, Korker V

机构信息

Perinatal Diagnostic Center, Inova Alexandria Hospital, Virginia 22304, USA.

出版信息

Am J Perinatol. 1999;16(8):403-6. doi: 10.1055/s-1999-6819.

Abstract

Postamniocentesis chorioamnionitis is usually managed with induction of labor to prevent maternal sepsis and related morbidity and mortality. We report a case of chorioamnionitis in a triplet pregnancy after midtrimester genetic amniocentesis, in which multiple antibiotic treatment (ampicillin 2 g i.v. loading dose followed by 1 g i.v. every 6 hr; clindamycin 900 mg i.v. every 8 hr; gentamicin 120 mg i.v. loading dose followed by 100 mg i.v. every 8 hrs; and erythromycin 500 mg i.v. every 6 hr) for 7 days and delivery of the presumably infected triplet A successfully reversed the clinical symptomatology, allowing prolongation of pregnancy until 26 weeks and survival of the remaining fetuses. At age 2 years, both infants are doing well and are meeting their developmental milestones. The viable outcome of this management strategy suggests that antibiotic treatment and expectancy may be an option in selected cases of postamniocentesis chorioamnionitis in multiple pregnancies.

摘要

羊膜腔穿刺术后绒毛膜羊膜炎通常通过引产来处理,以预防产妇败血症及相关的发病率和死亡率。我们报告一例孕中期遗传羊膜腔穿刺术后三胎妊娠合并绒毛膜羊膜炎的病例,该病例中采用多种抗生素治疗(氨苄西林静脉注射负荷剂量2 g,随后每6小时静脉注射1 g;克林霉素每8小时静脉注射900 mg;庆大霉素静脉注射负荷剂量120 mg,随后每8小时静脉注射100 mg;红霉素每6小时静脉注射500 mg)7天,并分娩出可能感染的胎儿A,成功逆转了临床症状,使妊娠得以延长至26周,其余胎儿存活。在2岁时,两个婴儿情况良好,达到了各自的发育里程碑。这种管理策略的可行结果表明,在多胎妊娠的羊膜腔穿刺术后绒毛膜羊膜炎的某些特定病例中,抗生素治疗和期待疗法可能是一种选择。

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