Singh Pradeep K, Shrivastva Deepti, Paddalwar Snigdha, Shetty Nagraj, Raut Vipin, Patnaik Sarthak, Yadav Abhishek
Department of Orthopaedics and Trauma, DMIMS, Wardha, India.
J Surg Tech Case Rep. 2011 Jan;3(1):52-5. doi: 10.4103/2006-8808.78477.
Trauma is the leading nonobstetric cause of maternal death. The worst complication can be fetal compromise that threatens premature labor or even fetal death. We are reporting a case of a 30-year-old primi, short stature woman who had fracture femur with hypovolaemic shock. Managing such trauma complicated by shock in a pregnant patient needs multidisciplinary approach. Clinician team evaluating and coordinating the care of pregnant trauma patient should understand the pathophysiological changes in pregnancy with trauma to manage hypovolaemic shock, related complications, treatment of fracture, and radiation exposure to the fetus. The use of imaging studies, invasive hemodynamics and surgery, if necessary, should be individualized. A clear understanding of fetal viability, physiological changes of pregnancy, and pathophysiology of shock, is mandatory for optimal, maternal functional, and obstetrical outcome.
创伤是孕产妇非产科死亡的首要原因。最严重的并发症可能是胎儿窘迫,这会威胁早产甚至胎儿死亡。我们报告一例30岁初产妇、身材矮小的女性,她发生了股骨骨折并伴有低血容量性休克。处理此类合并休克的创伤孕妇需要多学科方法。评估和协调创伤孕妇护理的临床医生团队应了解创伤合并妊娠时的病理生理变化,以处理低血容量性休克、相关并发症、骨折治疗以及胎儿的辐射暴露。如有必要,影像检查、有创血流动力学监测及手术的使用应个体化。对于实现最佳的母体功能和产科结局而言,清楚了解胎儿生存能力、妊娠生理变化及休克病理生理学是必不可少的。