Buechel Johanna, Berset Andreas, Lehmann Michael A, Lapaire Olav
Department of Obstetrics and Gynecology, Universitätsspital Basel, Basel, Switzerland.
Department of Anesthesiology, Universitätsspital Basel, Basel, Switzerland.
BMJ Case Rep. 2015 Apr 16;2015:bcr2015209765. doi: 10.1136/bcr-2015-209765.
Amniotic fluid embolism, also called anaphylactoid syndrome of pregnancy, is a rare but severe problem in obstetrics. It occurs in 8/100,000 births and the maternal mortality is up to 90%. We report the case of a patient with amniotic fluid embolism who was transferred to our hospital. The initial presentation was an unresponsive patient after spontaneous rupture of the membranes. The massive hypotension and coagulopathy as well as fetal bradycardia of 60 bpm led, after stabilisation of the mother, to an emergency caesarean section. The neonate expired hours later, despite neonatological intensive care. During the operation, we had to deal with massive bleeding due to the coagulopathy. Through interdisciplinary teamwork including Bakri postpartum balloon insertion through the obstetrics team, uterine artery embolism by the interventional radiologists and transfusion of blood products, the maternal life was saved and the patient was discharged 9 days after admission.
羊水栓塞，也称为妊娠过敏样综合征，是产科中一种罕见但严重的问题。其发生率为每10万例分娩中有8例，孕产妇死亡率高达90%。我们报告一例羊水栓塞患者转至我院的病例。最初表现为胎膜自然破裂后患者无反应。在母亲病情稳定后，严重低血压、凝血病以及胎儿心率降至60次/分钟导致紧急剖宫产。尽管新生儿接受了新生儿重症监护，但数小时后仍死亡。手术期间，我们不得不应对因凝血病导致的大量出血。通过包括产科团队插入Bakri产后球囊、介入放射科医生进行子宫动脉栓塞以及输注血液制品在内的多学科团队协作，产妇生命得以挽救，患者入院9天后出院。
