孕期自发性脊髓硬膜外血肿与使用低分子量肝素相关。
Spontaneous spinal epidural hematoma in pregnancy associated with using low molecular weight heparin.
作者信息
Forsnes Evan, Occhino Amy, Acosta Reinaldo
机构信息
From the Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, and Obstetric Hospitalist Program, Sacred Heart Medical Center, Spokane, Washington.
出版信息
Obstet Gynecol. 2009 Feb;113(2 Pt 2):532-533. doi: 10.1097/AOG.0b013e31818f52d1.
BACKGROUND
Spontaneous epidural hematoma of the spine occurring in pregnancy is uncommon and may result in permanent damage if not promptly treated. The use of low molecular weight heparin may be a risk factor for this condition.
CASE
We describe the case of a woman who presented at 27 weeks of gestation with progressive back pain and leg weakness while being treated with low molecular weight heparin. A magnetic resonance imaging (MRI) examination of the spine revealed an epidural hematoma, which was surgically treated. A cesarean delivery was performed at 36 weeks of gestation.
CONCLUSION
Spontaneous epidural hematoma of the spine may present in pregnant patients using low molecular weight heparin. The onset of neurologic symptoms and pain in these gravidas should be evaluated with MRI. Expeditious surgery is almost always the best treatment option.
背景
妊娠期间发生的自发性脊柱硬膜外血肿并不常见，若不及时治疗可能导致永久性损伤。使用低分子量肝素可能是这种情况的一个危险因素。
病例
我们描述了一名在妊娠27周时出现进行性背痛和腿部无力的女性病例，当时她正在接受低分子量肝素治疗。脊柱磁共振成像（MRI）检查显示硬膜外血肿，遂进行了手术治疗。妊娠36周时进行了剖宫产。
结论
使用低分子量肝素的孕妇可能出现自发性脊柱硬膜外血肿。对于这些孕妇出现的神经症状和疼痛发作，应进行MRI评估。迅速手术几乎总是最佳治疗选择。
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