Départment d'Anesthésie-Réanimation Adultes, Clermont-Ferrand Cedex, France.
Int J Obstet Anesth. 2012 Oct;21(4):364-7. doi: 10.1016/j.ijoa.2012.05.004. Epub 2012 Aug 2.
A previously healthy 31-year-old G4P2 woman at 33 weeks of gestation was admitted as an emergency with a pyrexia of 39°C, vomiting, headache and neck stiffness associated with photophobia, phonophobia and visual and auditory symptoms. There were no heraldic signs of eclampsia. Polymerase chain reaction and testing for herpes simplex virus in the cerebrospinal fluid diagnosed herpes simplex-1 meningoencephalitis. Following acyclovir, the clinical course improved. Spontaneous vaginal delivery occurred at 39 weeks of gestation with epidural analgesia using ropivacaine. Mother and child were neurologically normal and healthy 15 months later. Early administration of acyclovir is essential to reduce the risk of neurological complications. After treatment and a negative polymerase chain reaction for herpes simplex virus in the cerebrospinal fluid, epidural analgesia with local anesthetic and sufentanil is possible.
一位 33 孕周、既往健康的 G4P2 女性因 39°C 发热、呕吐、头痛和颈项强直伴畏光、恐声和视觉及听觉症状急诊入院。无子痫的先兆症状。聚合酶链反应和单纯疱疹病毒检测脑脊液诊断为单纯疱疹病毒 1 型脑膜脑炎。使用阿昔洛韦后，临床情况改善。产妇在 39 孕周行硬膜外分娩镇痛，使用罗哌卡因。母亲和婴儿 15 个月后神经功能均正常，健康状况良好。早期使用阿昔洛韦可降低神经并发症风险。单纯疱疹病毒治疗和脑脊液聚合酶链反应转阴后，可行局部麻醉和舒芬太尼的硬膜外分娩镇痛。
