Oi Chikako, Hori Yasuo, Sano Hiroaki, Yamama Yoshihiro, Nakatani Keiji
Masui. 2015 Nov;64(11):1186-9.
Amniotic fluid embolism (AFE) is a disorder with a high mortality rate. We present a case of AFE with cardiac arrest during the cesarean section who recovered sequela. A 28-year-old woman was diagnosed as low lying placenta and planned to undergo cesarean section in 38th gestational week. She had atypical genital bleeding in 32nd gestational weeks and she received emergency cesarean section under general anesthesia. After expulsion of her fetus, she lost many blood. We suspected obstetric DIC and started therapy immediately, but cardiac arrest occurred suddenly. She was resuscitated, and we decided to suspend the operation with temporary gauze-packing. After in better general condition, we removed the packed gauze from her abdomen. She could leave the intensive care unit 7 days after the first operation. In this case, the crucial points for successful resuscitation were prompt obstetric anesthesiologist involvement and good communication with obstetricians.
羊水栓塞(AFE)是一种死亡率很高的疾病。我们报告一例剖宫产术中发生心脏骤停并遗留后遗症后康复的羊水栓塞病例。一名28岁女性被诊断为前置胎盘,计划在孕38周时行剖宫产术。她在孕32周时出现非典型阴道出血,在全身麻醉下行急诊剖宫产术。胎儿娩出后,她大量失血。我们怀疑发生了产科弥散性血管内凝血(DIC)并立即开始治疗,但突然发生了心脏骤停。她被复苏成功,我们决定用临时纱布填塞暂停手术。在一般情况好转后,我们从她腹部取出填塞的纱布。首次手术后7天,她能够离开重症监护病房。在该病例中,成功复苏的关键点是产科麻醉医生及时介入以及与产科医生的良好沟通。