Kim I, Lindeman K, Masear C
The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287, USA.
The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287, USA.
Int J Obstet Anesth. 2018 Nov;36:111-114. doi: 10.1016/j.ijoa.2018.05.006. Epub 2018 May 29.
Raynaud's disease is a medical condition in which arterial spasm causes episodes of reduced blood flow, in the setting of certain triggers such as cold weather. Patients with this condition are at risk of adverse reactions if they receive medications with vasoactive properties. Methylergonovine maleate is one drug used during cesarean delivery to treat postpartum hemorrhage due to uterine atony. By acting directly on uterine and vascular smooth muscle, it produces cardiovascular responses such as coronary vasospasm, myocardial infarction, and even cardiac arrest. However, pulmonary events have rarely been reported. We report our anesthetic management of a 36-year-old patient, with undiagnosed Raynaud's disease and undergoing cesarean delivery, who experienced new onset acute pulmonary edema after methylergonovine administration to manage postpartum hemorrhage.
雷诺氏病是一种医学病症，在诸如寒冷天气等特定诱因的情况下，动脉痉挛会导致血流减少发作。患有这种病症的患者如果接受具有血管活性特性的药物，会有发生不良反应的风险。马来酸甲基麦角新碱是剖宫产时用于治疗因子宫收缩乏力引起的产后出血的一种药物。它通过直接作用于子宫和血管平滑肌，会产生诸如冠状动脉痉挛、心肌梗死甚至心脏骤停等心血管反应。然而，肺部事件鲜有报道。我们报告了一名36岁未被诊断出患有雷诺氏病且正在接受剖宫产的患者的麻醉管理情况，该患者在使用马来酸甲基麦角新碱治疗产后出血后出现了新发急性肺水肿。
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