Bennett Michael
Emergency Department, Adelaide and Meath incorporating the National Children's Hospital, Dublin, Ireland.
BMJ Case Rep. 2011 Oct 28;2011:bcr0820114693. doi: 10.1136/bcr.08.2011.4693.
A 32-year-old female para 4 gravi 3, who was 21 weeks pregnant, presented to the emergency department (ED) with a 2-day history of abdominal pain, headache, blurred vision and vomiting. On arrival, she was agitated and confused with a blood pressure 162/106 mm Hg, pulse rate 107, respiratory rate 18, temperature 37 degrees Celsius, point of care blood glucose 6.2 and her Glasgow coma scale was 13/15 M6V4E3. Paramedics witnessed seizure-like activity lasting <1 min during transport. A diagnosis of eclampsia complicated by the HELLP syndrome (haemolysis, elevated liver enzymes, low platelets count) was made. She was commenced on magnesium and labetalol intravenously for blood pressure control. Initial blood test results were consistent with the HELLP syndrome. Recognition of the HELLP syndrome with prompt management of blood pressure and clotting abnormalities is essential in the ED setting. An aggressive multidisciplinary approach is a key to optimise the prognosis for mother and fetus.
一名32岁、孕4产3的女性，怀孕21周，因腹痛、头痛、视力模糊和呕吐2天就诊于急诊科。入院时，她烦躁不安且意识模糊，血压162/106毫米汞柱，脉搏率107次/分，呼吸频率18次/分，体温37摄氏度，即时血糖6.2，格拉斯哥昏迷量表评分为13/15（运动6分、语言4分、睁眼3分）。护理人员在转运过程中目睹了持续不到1分钟的癫痫样活动。诊断为子痫并发HELLP综合征（溶血、肝酶升高、血小板计数降低）。她开始静脉注射硫酸镁和拉贝洛尔以控制血压。初步血液检查结果与HELLP综合征相符。在急诊科环境中，识别HELLP综合征并及时处理血压和凝血异常至关重要。积极的多学科方法是优化母婴预后的关键。
