Imanaka Hideaki, Takahara Bunji, Yamaguchi Harutaka, Nakataki Emiko, Mano Akiko, Inui Daisuke, Oto Jun, Nishimura Masaji
Department of Emergency and Critical Care, The University of Tokushima Graduate School, Kuramoto Tokushima, 770-8503, Japan.
J Med Case Rep. 2010 Feb 18;4:55. doi: 10.1186/1752-1947-4-55.
Amniotic fluid embolism is one of the most severe complications in the peripartum period. Because its onset is abrupt and fulminant, it is unlikely that there will be time to examine the condition using thoracic computed tomography (CT). We report a case of life-threatening amniotic fluid embolism, where chest CT in the acute phase was obtained.
A 22-year-old Asian Japanese primiparous woman was suspected of having an amniotic fluid embolism. After a Cesarean section for cephalopelvic disproportion, her respiratory condition deteriorated. Her chest CT images were examined. CT findings revealed diffuse homogeneous ground-glass shadow in her bilateral peripheral lung fields. She was therefore transferred to our hospital. On admission to our hospital's intensive care unit, she was found to have severe hypoxemia, with SpO2 of 50% with a reservoir mask of 15 L/min oxygen. She was intubated with the support of noninvasive positive pressure ventilation. She was successfully extubated on the sixth day, and discharged from the hospital on the twentieth day.
This is the first case report describing amniotic fluid embolism in which CT revealed an acute respiratory distress syndrome-like shadow.
羊水栓塞是围产期最严重的并发症之一。由于其发病突然且迅猛，不太可能有时间使用胸部计算机断层扫描（CT）来检查病情。我们报告一例危及生命的羊水栓塞病例，其中急性期进行了胸部CT检查。
一名22岁的亚洲日本初产妇被怀疑发生羊水栓塞。因头盆不称行剖宫产术后，她的呼吸状况恶化。对其胸部CT图像进行了检查。CT结果显示双侧肺外周野弥漫性均匀磨玻璃影。因此她被转至我院。入住我院重症监护病房时，发现她有严重低氧血症，使用15L/分钟氧气储氧面罩时SpO2为50%。在无创正压通气支持下进行了气管插管。她在第6天成功拔管，并于第20天出院。
这是首例描述CT显示急性呼吸窘迫综合征样阴影的羊水栓塞病例报告。
