Afifi A, Descamps P H, Hamoud A, Pariente E A
Service de Chirurgie viscérale B, Centre Hospitalier d' Orléans.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(4):455-8.
The authors report a case of jaundice occurring secondary to severe vomiting in pregnancy in the first trimester. This is a rare clinical entity (occurring in 0.2-3 cases per thousand) although some people say it does not exist. The physiopathology is still badly understood but it occurs most often between the fourth and eighth week of amenorrhoea. It is characterised by jaundice occurring secondarily to vomiting in the first trimester, with a rise in the bilirubin level in the blood and in the alkaline phosphatases. Sometimes there is a slight rise in the transaminases. The diagnosis can only be arrived at after having excluded all the other possible causes of jaundice which are mentioned in the text. Furthermore the way the condition progresses is an important argument for its aetiology because once vomiting ceases the jaundice goes. The treatment has to be symptomatic with correction of the dehydration.
作者报告了一例孕早期因严重呕吐继发黄疸的病例。这是一种罕见的临床病症(每千例中发生0.2 - 3例),尽管有些人认为它并不存在。其病理生理过程仍未被充分理解,但最常发生在闭经后的第四至八周。其特征为孕早期呕吐继发黄疸,血液中胆红素水平及碱性磷酸酶升高。有时转氨酶也会略有升高。只有在排除本文提及的所有其他可能导致黄疸的原因后才能做出诊断。此外,病情的发展方式对其病因学来说是一个重要依据,因为一旦呕吐停止,黄疸就会消退。治疗必须是对症治疗并纠正脱水。