慢性肾衰竭合并前置胎盘产妇行椎管内麻醉的安全性。
Safe spinal anesthesia in a woman with chronic renal failure and placenta previa.
机构信息
Kahramanmaras, Turkey.
出版信息
Int J Gen Med. 2010 Jul 21;3:153-6. doi: 10.2147/ijgm.s11421.
BACKGROUND
Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.
CASE PRESENTATION
A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days' gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.
CONCLUSION
Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.
背景
慢性肾衰竭与不良妊娠结局密切相关。在妊娠前就依赖血液透析的女性很少能成功分娩活产儿。
病例介绍
一位 31 岁的多产妇土耳其女性因继发性前置胎盘出血，在妊娠 37 周零 5 天的时候接受椎管内麻醉下剖宫产术。成功进行了 8 毫克重比重布比卡因的椎管内麻醉。手术过程中，有创血压、中心静脉压和心率均保持稳定。母亲在术后第一天就恢复了常规血液透析。
结论
慢性肾衰竭需要慢性透析的女性妊娠并不常见。患有慢性透析的孕妇的高血压、子痫前期、贫血和感染发生率很高。然而，我们的研究结果表明，通过术前和术中的仔细、密切和有效的监测，椎管内麻醉可安全用于血液透析患者的剖宫产术。
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