Birch Samuel, Lu Corrine
Cardiology department, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
Department of Obstetrics and Gynaecology, Centenary Hospital for Women and Children, Canberra Hospital, Garran, Australian Capital Territory, Australia.
BMJ Case Rep. 2019 Feb 13;12(2):e226747. doi: 10.1136/bcr-2018-226747.
A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony. The patient immediately developed atrial fibrillation (AF). AF is the most common sustained arrhythmia in the general population, but is rare in the obstetric population. AF occurring in an intrapartum setting following the administration of syntocinon and ergometrine, is not documented in the literature. We suggest the initiation of paroxysmal AF was precipitated by an abrupt alteration in autonomic tone caused by administration of syntocinon followed by ergometrine.
一名有过一次剖宫产史的36岁女性，在孕39⁺²/40周时胎膜自然破裂，被送往一家地区医院的分娩室。由于患者希望顺产，在未临产的情况下使用了缩宫素以启动子宫收缩。随后决定进行剖宫产，并使用麦角新碱治疗宫缩乏力。患者随即出现房颤（AF）。房颤是普通人群中最常见的持续性心律失常，但在产科人群中很少见。文献中未记载在使用缩宫素和麦角新碱后产时发生房颤的情况。我们认为，阵发性房颤的发作是由先使用缩宫素后使用麦角新碱导致自主神经张力突然改变所诱发的。
