Desgranges F-P, Berthelot A-L, Gamondes D, Amanieu C, Audra P, Bastien O, Lehot J-J
Service d'anesthésie-réanimation, hôpital cardiologique et pneumologique Louis-Pradel, groupement hospitalier Est, hospices civils de Lyon, université Claude-Bernard Lyon-1, 28, avenue du Doyen-Lépine, 69677 Bron cedex, France.
Ann Fr Anesth Reanim. 2010 Nov;29(11):811-4. doi: 10.1016/j.annfar.2010.08.007. Epub 2010 Oct 8.
Massive haemoptysis are rare in pregnant woman. Besides usual causes of haemoptysis, cases of idiopathic haemoptysis have been described during pregnancy, probably with a hormonal role. A pregnant woman at 22 weeks amenorrhoea was admitted in intensive care unit for massive and recurrent haemoptysis, enhanced by bouts of hypertension in a context of preeclampsia. Arteriography showed bronchial hypervascularisation, with abnormally dilated bronchial arteries, and a lot of collateral arteries. Three sessions of bronchial artery embolization have been performed with success. The management of idiopathic haemoptysis in pregnant woman seems to be based on the usual algorithm of management, emphasizing on the control of blood pressure, and the key role of interventional radiology.
大量咯血在孕妇中较为罕见。除了常见的咯血原因外,孕期特发性咯血病例也有报道,可能与激素作用有关。一名停经22周的孕妇因大量反复咯血入住重症监护病房,在子痫前期背景下,高血压发作使咯血加重。动脉造影显示支气管血管增多,支气管动脉异常扩张,并有许多侧支动脉。已成功进行了三次支气管动脉栓塞治疗。孕妇特发性咯血的管理似乎基于常规管理方案,强调血压控制以及介入放射学的关键作用。