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重度子痫前期及围产期心肌病急诊剖宫产术中的心搏骤停

Cardiac arrest during emergency cesarean section for severe pre-eclampsia and peripartum cardiomyopathy.

作者信息

Chou Meng-Han, Huang Hsin-Hui, Lai Yu-Ju, Hwang Kwei-Shuai, Wang Yu-Chi, Su Her-Young

机构信息

Department of General Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.

Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2016 Feb;55(1):125-7. doi: 10.1016/j.tjog.2015.12.010.

Abstract

OBJECTIVE

To present the correlation between severe pre-eclampsia and peripartum cardiomyopathy in pregnancy.

CASE REPORT

A 41-year-old parturient, gravida 3, para 1, at 34 4/7 weeks' gestation, was diagnosed with severe pre-eclampsia. At the time of admission, a plain chest film disclosed bilateral pleural effusions. An emergent cesarean section was planned because of decreased fetal movement, heavy daily protein loss, and bilateral pleural effusions. During the cesarean section, she developed shock with acute respiratory failure. She underwent advanced cardiac life support and intubation with mechanical ventilator support. Peripartum cardiomyopathy was subsequently diagnosed by echocardiography.

CONCLUSION

The presented case demonstrates that routine echocardiography is highly recommended for suspected peripartum cardiomyopathy in gravidas with severe pre-eclampsia and symptoms or signs of heart failure.

摘要

目的

阐述妊娠期间重度子痫前期与围产期心肌病之间的相关性。

病例报告

一名41岁孕妇,孕3产1,妊娠34 4/7周,被诊断为重度子痫前期。入院时,胸部X线平片显示双侧胸腔积液。由于胎动减少、每日大量蛋白质流失以及双侧胸腔积液,计划行急诊剖宫产术。剖宫产术中,她出现休克并伴有急性呼吸衰竭。她接受了高级心脏生命支持并插管进行机械通气支持。随后经超声心动图诊断为围产期心肌病。

结论

本病例表明,对于患有重度子痫前期且有心力衰竭症状或体征的孕妇,若怀疑有围产期心肌病,强烈建议进行常规超声心动图检查。

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