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一例经多学科治疗成功治愈的羊水栓塞病例。

A case of amniotic fluid embolism successfully treated by multidisciplinary treatment.

作者信息

Kinishi Yuki, Ootaki Chiyo, Iritakenishi Takeshi, Fujino Yuji

机构信息

Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

出版信息

JA Clin Rep. 2019 Nov 28;5(1):79. doi: 10.1186/s40981-019-0296-0.

DOI:10.1186/s40981-019-0296-0
PMID:32026080
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6967009/
Abstract

BACKGROUND

Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency. Because the maternal mortality associated with AFE is very high, early recognition and prompt treatment are important for improving the prognosis. We report a case of amniotic fluid embolism successfully treated by multidisciplinary treatment.

CASE PRESENTATION

A 39-year-old woman with fetal congenital heart anomaly and polyhydramnios was scheduled for induction of delivery at 37 weeks of gestation with labor epidural analgesia. Uncontrollable bleeding occurred 30 min after vaginal delivery. Based on the clinical diagnosis of AFE, massive blood transfusion, insertion of an aortic occlusion balloon catheter, and hysterectomy was performed. Total blood loss was 12,000 mL. The diagnosis of AFE was confirmed by pathological examination. She was discharged with no complications.

CONCLUSION

We report a case of AFE who were rescued by prompt diagnosis and treatment.

摘要

背景

羊水栓塞(AFE)是一种危及生命的产科急症。由于与羊水栓塞相关的孕产妇死亡率非常高,早期识别和及时治疗对于改善预后很重要。我们报告一例通过多学科治疗成功治愈的羊水栓塞病例。

病例介绍

一名39岁患有胎儿先天性心脏异常和羊水过多的女性计划在妊娠37周时进行引产并采用分娩硬膜外镇痛。阴道分娩后30分钟出现无法控制的出血。基于羊水栓塞的临床诊断,进行了大量输血、插入主动脉阻断球囊导管和子宫切除术。总失血量为12000毫升。通过病理检查确诊为羊水栓塞。她出院时无并发症。

结论

我们报告一例通过及时诊断和治疗获救的羊水栓塞病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc39/6967009/2b5dbdb2f76e/40981_2019_296_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc39/6967009/2b5dbdb2f76e/40981_2019_296_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc39/6967009/2b5dbdb2f76e/40981_2019_296_Fig1_HTML.jpg

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本文引用的文献

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Amniotic fluid embolism: update and review.羊水栓塞:最新进展与综述
Curr Opin Anaesthesiol. 2016 Jun;29(3):288-96. doi: 10.1097/ACO.0000000000000328.
2
Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.日本妊娠相关孕产妇死亡的现状:来自日本孕产妇死亡调查委员会的报告。
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Amniotic fluid embolism pathophysiology suggests the new diagnostic armamentarium: β-tryptase and complement fractions C3-C4 are the indispensable working tools.
羊水栓塞的病理生理学提示了新的诊断手段:β- 凝血酶和补体 C3 - C4 是不可或缺的实用工具。
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BMC Pregnancy Childbirth. 2012 Feb 10;12:7. doi: 10.1186/1471-2393-12-7.
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Clin Dev Immunol. 2012;2012:946576. doi: 10.1155/2012/946576. Epub 2011 Sep 29.
10
Postpartum hemorrhage resulting from uterine atony after vaginal delivery: factors associated with severity.阴道分娩后宫缩乏力导致的产后出血:严重程度相关因素。
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