Frontera Jennifer A, Ahmed Wamda
Cerebrovascular Center of the Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Neuroscience Intensive Care Unit, Departments of Neurology, Emory, Atlanta, Georgia.
J Crit Care. 2014 Dec;29(6):1069-81. doi: 10.1016/j.jcrc.2014.07.010. Epub 2014 Jul 11.
Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus.
妊娠和产褥期的神经重症监护并发症,如先兆子痫/子痫、溶血、肝酶升高、血小板减少综合征、血栓性血小板减少性紫癜、癫痫发作、缺血性和出血性中风、产后血管病、脑窦血栓形成、羊水栓塞、绒毛膜癌和妊娠急性脂肪肝虽然罕见,但可能具有毁灭性。这些情况对医生来说是一项挑战,因为妊娠是一种独特的生理状态,重症监护病房中可用的大多数治疗选择并未在孕妇中进行研究,而且在许多情况下,医生需要同时为母亲和胎儿提供治疗。及时识别和处理妊娠/产褥期的严重神经系统并发症对母亲和胎儿都可能挽救生命。