Winston Anthony W, Norman David
Navy Nurse Corps Anesthesia Program, Naval School of Health Sciences, Portsmouth, Va., USA.
AANA J. 2003 Oct;71(5):371-2.
Preeclampsia developed in this patient 4 days' postpartum. Visual changes, headache, and elevated blood pressures were present on arrival to the emergency department. Coincident with the preeclampsia was a postdural puncture headache complicating the diagnosis of late postpartum preeclampsia. Pregnancy-induced hypertension laboratory values were normal, and relief of the postdural headache and visual disturbances was obtained after placement of an epidural blood patch. Blood pressures continued to increase, however, and late postpartum eclampsia developed. We conclude that symptoms of a postdural puncture headache can mimic those of postpartum preeclampsia. Early recognition and treatment of postpartum preeclampsia may decrease patient mortality and morbidity by preventing late postpartum eclampsia.
该患者产后4天发生子痫前期。到达急诊科时出现视力变化、头痛和血压升高。与子痫前期同时存在的是硬膜外穿刺后头痛,使晚发型产后子痫前期的诊断复杂化。妊娠高血压相关实验室检查值正常,硬膜外血贴置入后硬膜外穿刺后头痛和视觉障碍得到缓解。然而,血压持续升高,随后发生了晚发型产后子痫。我们得出结论,硬膜外穿刺后头痛的症状可能与产后子痫前期的症状相似。早期识别和治疗产后子痫前期可通过预防晚发型产后子痫来降低患者的死亡率和发病率。