Kobayashi T, Tokunaga N, Isoda H, Kanayama N, Terao T
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan.
Semin Thromb Hemost. 2001;27(2):131-5. doi: 10.1055/s-2001-14071.
We attempted to prove the occurrence of generalized vasospasms in cases with eclampsia/preeclampsia and HELLP syndrome and to suggest the existence of an angiospastic syndrome of pregnancy. Sixteen cases with severe preeclampsia were evaluated. Among them, three cases were complicated by eclampsia and one case with HELLP syndrome. Cranial magnetic resonance angiography (MRA) was performed in 15 cases, and celiac angiography was performed in one case. Vasospasms were observed in 12 cases (75.0%), including all cases involving eclampsia and HELLP syndrome, and cerebral infarction was observed in one case. Typical vasospasms were found by MRA in the middle and posterior cerebral arteries with peripheral ischemic changes in cases with severe preeclampsia and eclampsia. Vasospasms of the hepatic arteries were observed by celiac angiography in a case with HELLP syndrome. Vasospasms are characteristic for patients with eclampsia/preeclampsia and HELLP syndrome, and the existence of an angiospastic syndrome of pregnancy is proposed.
我们试图证明子痫/子痫前期和HELLP综合征患者会发生全身性血管痉挛,并提示存在妊娠血管痉挛综合征。对16例重度子痫前期患者进行了评估。其中,3例并发子痫,1例患有HELLP综合征。15例行头颅磁共振血管造影(MRA),1例行腹腔血管造影。12例(75.0%)观察到血管痉挛,包括所有子痫和HELLP综合征病例,1例观察到脑梗死。在重度子痫前期和子痫病例中,通过MRA在大脑中动脉和后动脉发现典型血管痉挛,并伴有外周缺血改变。在1例HELLP综合征患者中,通过腹腔血管造影观察到肝动脉血管痉挛。血管痉挛是子痫/子痫前期和HELLP综合征患者的特征,因此提出存在妊娠血管痉挛综合征。