Fernández E, Dueñas N, Villafranca A, Perea M, Amorós B, Bermejo L
Departamento de Anestesiologia, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Anestesiol Reanim. 2010 May;57(5):307-10. doi: 10.1016/s0034-9356(10)70232-2.
Emergency cesarean section is a high-risk situation because of potential maternal-fetal complications. We report a case in which risk increased due to a massive thrombus in the mother's left common femoral vein extending to the vena cava. A 31-year-old woman with no relevant medical history in the 41st week of pregnancy was scheduled for induction. Two days before the planned induction she was admitted to the emergency department, where she was diagnosed with deep vein thrombosis in the left lower limb. She was transferred to the postanesthetic recovery unit, where a multidisciplinary team (from gynecology, hematology, interventional radiology, and anesthesiology) discussed various therapeutic options (thrombectomy, vena cava filter, or anticoagulation by intravenous infusion of unfractionated heparin). Given that deep vein thrombosis coincided with obstetric delivery, it was crucial to decide on anesthetic and therapeutic approaches that would assure maternal and fetal safety and prevent such complications as massive pulmonary thromboembolism.
急诊剖宫产是一种高风险情况，因为存在潜在的母婴并发症。我们报告一例由于母亲左股总静脉内巨大血栓延伸至腔静脉导致风险增加的病例。一名31岁、孕期41周且无相关病史的女性计划引产。在计划引产的前两天，她被收入急诊科，在那里被诊断为左下肢深静脉血栓形成。她被转至麻醉后恢复病房，一个多学科团队（来自妇科、血液科、介入放射科和麻醉科）讨论了各种治疗方案（血栓切除术、腔静脉滤器或静脉输注普通肝素进行抗凝）。鉴于深静脉血栓形成与产科分娩同时发生，决定采用能确保母婴安全并预防大规模肺血栓栓塞等并发症的麻醉和治疗方法至关重要。
