Rahmoune F C, Aya G, Biard M, Belkhayat G, Hamza J, Leperc J, Ouchtati M
Département d'anesthésie-réanimation, hôpital Saint-Vincent-de-Paul, 82 avenue Denfert-Rochereau, Paris, France.
Ann Fr Anesth Reanim. 2011 Feb;30(2):156-8. doi: 10.1016/j.annfar.2010.11.024. Epub 2011 Feb 1.
Haemorrhages during pregnancy may have a non-obstetrical origin, the pregnancy itself favoring some specific aetiologies because of pregnancy-related physiological modifications. These non-obstetrical haemorrhages are rare but are associated with a high maternal and foetal mortality. The prognosis depends on an early diagnosis and a multidisciplinary approach. We report the case of a patient who had a caesarean section for suspicion of acute foetal distress during which was found a large intraperitoneal bleeding due to rupture of an unknown splenic artery aneurysm. We discuss the principal causes of non-obstetrical intra-abdominal bleeding, including subcapsular liver haematoma, rupture of uterine vessels and rupture of splenic artery aneurysm, with a specific focus on this last aetiology.
孕期出血可能源于非产科因素,由于妊娠相关的生理改变,妊娠本身会促使某些特定病因的出现。这些非产科出血虽罕见,但与母婴高死亡率相关。预后取决于早期诊断和多学科方法。我们报告一例患者,因怀疑急性胎儿窘迫而行剖宫产,术中发现因不明脾动脉瘤破裂导致大量腹腔内出血。我们讨论非产科腹腔内出血的主要原因,包括肝包膜下血肿、子宫血管破裂和脾动脉瘤破裂,特别关注最后一种病因。