Higueras R, Beltrán M, Peral D, Ferrándiz L, Barrachina C, Barberá M
Servicio de Anestesiología y Reanimación, Hospital Universitario Doctor Peset Aleixandre, Valencia.
Rev Esp Anestesiol Reanim. 2007 Mar;54(3):184-7.
Pre-eclampsia is a serious obstetric complication associated with a high rate of maternal and fetal morbidity and mortality. We report the case of a woman with a medical history of insulin-dependent diabetes mellitus and seizures possibly related to hypoglycemia who was admitted for an emergency cesarian due to severe pre-eclampsia and macrosomic fetus. In the first hour after delivery she experienced loss of consciousness and seizure, with vaginal bleeding and hypovolemic shock. Maximum vigilance is required for a patient with several concomitant diseases and a high-risk pregnancy. All prophylactic measures to lower the risk to mother and fetus should be undertaken. We analyze preanesthetic assessment, differential diagnosis, and choice of anesthesia in relation to this case.
子痫前期是一种严重的产科并发症，与母婴高发病率和死亡率相关。我们报告一例有胰岛素依赖型糖尿病病史且可能与低血糖相关癫痫发作的女性病例，该患者因重度子痫前期和巨大胎儿入院接受急诊剖宫产。产后第一小时，她出现意识丧失和癫痫发作，并伴有阴道出血和低血容量性休克。对于患有多种合并症和高危妊娠的患者，需要保持最高警惕。应采取所有降低母婴风险的预防措施。我们结合该病例分析麻醉前评估、鉴别诊断及麻醉选择。
