Department of Obstetrics and Gynecology, University of Utah, Salt Lake, Utah, USA.
Obstet Gynecol. 2013 Feb;121(2 Pt 2 Suppl 1):422-4. doi: 10.1097/aog.0b013e3182758632.
Asthma remains a common chronic illness in pregnancy with the potential for catastrophic complications. Most women with asthma exacerbation can be treated with medical management and continuation of pregnancy. However, refractory cases may necessitate delivery for fetal or maternal indications.
We report a case of status asthmaticus at 33 weeks of gestation with significant maternal respiratory acidosis and difficulty with ventilation necessitating delivery by cesarean delivery in the medical intensive care unit. The patient was unresponsive to standard medical therapies. Delivery resulted in immediate improvement in maternal ventilation parameters.
In cases of life-threatening status asthmaticus refractory to standard medical and ventilatory therapies in the third trimester, cesarean delivery should be considered as a final effort to increase tidal volumes and improve maternal gas exchange.
哮喘仍然是妊娠期常见的慢性疾病,有发生灾难性并发症的潜在风险。大多数哮喘恶化的女性可以通过药物治疗和继续妊娠来治疗。然而,难治性病例可能需要根据胎儿或母体指征进行分娩。
我们报告了一例 33 周妊娠的哮喘持续状态,产妇呼吸性酸中毒严重,通气困难,需要在重症监护病房进行剖宫产分娩。该患者对标准的药物治疗无反应。分娩后,产妇通气参数立即得到改善。
在第三孕期,对于危及生命的难治性哮喘持续状态,在标准药物和通气治疗无效的情况下,应考虑剖宫产作为增加潮气量和改善产妇气体交换的最后手段。