Fukami Takehiko, Asakura Hirobumi, Takeshita Toshiyuki
Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.
J Nippon Med Sch. 2013;80(3):230-3. doi: 10.1272/jnms.80.230.
A 35-year-old primigravida with severe ovarian dysfunction underwent in vitro fertilization with oocytes donated by her sister. A twin pregnancy ensued, and she received prenatal care at our hospital. She underwent a cesarean section at 35 weeks' gestation because of pregnancy-induced hypertension (PIH) and breech presentation at the onset of labor. Eclampsia with a generalized seizure occurred 5 hours after the cesarean section, while the patient was receiving medical treatment for disseminated intravascular coagulation secondary to an atonic uterus. Reversible posterior leukoencephalopathy syndrome (RPLS) was diagnosed with magnetic resonance imaging the following day. With control of the hypertension and seizures, the condition of the patient was stabilized, and the RPLS resolved several days later. Eclampsia and RPLS associated with pregnancy can be life-threatening and are typically closely related to PIH. Thus, this case illustrates that the risk of PIH is increased in pregnancies produced with donated oocytes.
一名35岁的初产妇，患有严重的卵巢功能障碍，接受了其妹妹捐赠卵母细胞的体外受精。随后发生了双胎妊娠，她在我院接受了产前护理。由于妊娠高血压综合征（PIH）和临产前臀位，她在妊娠35周时接受了剖宫产。剖宫产术后5小时，患者在接受因子宫收缩乏力继发的弥散性血管内凝血的治疗时，发生了伴有全身性惊厥的子痫。第二天通过磁共振成像诊断为可逆性后部白质脑病综合征（RPLS）。随着高血压和惊厥得到控制，患者病情稳定，RPLS在几天后消退。与妊娠相关的子痫和RPLS可能危及生命，通常与PIH密切相关。因此，该病例表明，使用捐赠卵母细胞进行的妊娠中PIH风险增加。
