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[羊水栓塞:孤立性弥散性血管内凝血的成功演变过程及早期生物学诊断]

[Amniotic fluid embolism: successful evolution course of isolated disseminated intravascular coagulation and early biological diagnosis].

作者信息

Gamerre L, Tramoni G, Lhuillier F, Boisson C, Clement H-J, Viale J-P

机构信息

Département d'Anesthésie-Réanimation, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France.

出版信息

Ann Fr Anesth Reanim. 2006 Jun;25(6):633-7. doi: 10.1016/j.annfar.2006.03.034. Epub 2006 May 12.

Abstract

Amniotic embolism is a sudden, unexpected and devastating complication of pregnancy. The diagnosis is usually made on the basis of clinical presentation after excluding differential diagnosis or at autopsy in the event of death of the parturient. We need to develop simple, non-invasive, sensitive tests for a reliable and early diagnosis. We report the case of a 34-year-old woman, who presented soon after delivery, an isolated disseminated intravascular coagulation with severe haemorrhage, an haemostatic hysterectomy was required. A 3370 g child was delivered by caesarean section. The patient survived without sequelae. The diagnosis of amniotic embolism was established by the presence of amniotic cells in the maternal central venous blood as well as in the bronchoalveolar fluid.

摘要

羊水栓塞是一种妊娠期间突然发生、出乎意料且具有毁灭性的并发症。诊断通常基于排除鉴别诊断后的临床表现做出,或者在产妇死亡的情况下通过尸检确定。我们需要开发简单、无创且敏感的检测方法,以实现可靠的早期诊断。我们报告一例34岁女性病例,该患者产后不久出现单纯性弥散性血管内凝血并伴有严重出血,需要进行止血性子宫切除术。通过剖宫产分娩出一个体重3370克的婴儿。患者存活且无后遗症。通过在母体中心静脉血以及支气管肺泡灌洗液中发现羊水细胞,确立了羊水栓塞的诊断。

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