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紧急剖宫产术中麻醉与防护:新型冠状病毒感染孕妇的病例报告及文献复习。

Anesthesia and protection in an emergency cesarean section for pregnant woman infected with a novel coronavirus: case report and literature review.

机构信息

Department of Anesthesiology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157# West 5 road, Xi'an, 710004, Shaanxi, China.

出版信息

J Anesth. 2020 Aug;34(4):613-618. doi: 10.1007/s00540-020-02796-6. Epub 2020 May 19.

Abstract

An outbreak of novel coronavirus pneumonia occurred worldwide since December 2019, which had been named COVID-19 subsequently. It is extremely transmissive that infection in pregnant women were unavoidable. The delivery process will produce large amount of contaminated media, leaving a challenge for medical personnel to ensure both the safety of the mother and infant and good self-protection. Only rare cases of pregnant women with COVID-19 are available for reference. Here, we report a 30-year-old woman had reverse transcription polymerase chain reaction-confirmed COVID-19 at 36 weeks 2 days of gestation. Significant low and high variability of fetal heart rate baseline and severe variable decelerations were repeated after admission. An emergency cesarean section at 37 weeks 1 day of gestation under combined spinal and epidural anesthesia was performed with strict protection for all personnel. Anesthesia and operation went uneventfully. None of the participants were infected. We can conclude that when confronted with cesarean section in parturient with COVID-19, careful planning and detailed preparation can improve the safety of the mother and infant and reduce the risk of infection for medical staff to help preventing and controlling the epidemic.

摘要

自 2019 年 12 月以来,全球范围内爆发了新型冠状病毒肺炎,随后将其命名为 COVID-19。感染孕妇是不可避免的,因为它具有极强的传染性。分娩过程会产生大量受污染的介质,这给医务人员确保母婴安全和良好的自我保护带来了挑战。只有极少数 COVID-19 孕妇的病例可供参考。在这里,我们报告了一例 30 岁的女性,她在妊娠 36 周 2 天时经逆转录聚合酶链反应确诊 COVID-19。入院后,胎儿心率基线出现明显的高低变异和严重的可变减速,并反复出现。在蛛网膜下腔和硬膜外联合麻醉下,于妊娠 37 周 1 天进行紧急剖宫产,所有人员均进行严格保护。麻醉和手术均顺利进行。无参与者感染。我们可以得出结论,当面对 COVID-19 产妇的剖宫产时,仔细的计划和详细的准备可以提高母婴的安全性,并降低医务人员感染的风险,有助于预防和控制疫情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ab/7235437/d1a21b767b2f/540_2020_2796_Fig1_HTML.jpg

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