Harnett M J P, Hepner D L, Datta S, Kodali B S
Staff Anaesthetist, Department of Anaesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Anaesthesia. 2005 Nov;60(11):1068-72. doi: 10.1111/j.1365-2044.2005.04373.x.
Amniotic fluid embolism is a rare obstetric complication. The exact pathogenesis of this syndrome remains unknown and significant controversy exists whether coagulopathy should always be present. We used thromboelastography to assess the effect of amniotic fluid on coagulation and platelet function in pregnant women. Different volumes of amniotic fluid (10-60 microl) were added to blood (330 microl) from pregnant women and thromboelastography variables determined. There were three important findings. R time, reflecting time to first clot formation, was significantly decreased with the addition of 10 microl amniotic fluid; platelet function, as determined by Reopro-TEG technique, was increased with the addition of 30 microl of amniotic fluid; and there was no evidence of fibrinolysis in any samples studied. In conclusion, our study substantiates the hypothesis that coagulation profile changes are invariable accompaniments of amniotic fluid embolism.
羊水栓塞是一种罕见的产科并发症。该综合征的确切发病机制尚不清楚，对于凝血功能障碍是否总是存在也存在重大争议。我们使用血栓弹力图来评估羊水对孕妇凝血和血小板功能的影响。将不同体积（10 - 60微升）的羊水添加到孕妇的血液（330微升）中，并测定血栓弹力图变量。有三个重要发现。反映首次形成凝块时间的R时间，在添加10微升羊水后显著缩短；通过Reopro - TEG技术测定的血小板功能，在添加30微升羊水后增强；并且在所研究的任何样本中均未发现纤维蛋白溶解的证据。总之，我们的研究证实了凝血谱变化是羊水栓塞必然伴随症状的假说。
