急性绒毛膜羊膜炎合并对称性周围性坏疽。

Acute chorioamnionitis complicated with symmetrical peripheral gangrene.

机构信息

Women's Health Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.

Women's Health Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Taiwan J Obstet Gynecol. 2020 Nov;59(6):972-974. doi: 10.1016/j.tjog.2020.09.032.

DOI:10.1016/j.tjog.2020.09.032

PMID:33218425

Abstract

OBJECTIVE

Symmetrical peripheral gangrene (SPG) is an uncommon but important clinical syndrome. We present a case of acute chorioamnionitis complicated with SPG.

CASE REPORT

A 33-year-old female (gravida 5, para 2) was admitted with preterm premature rupture of membranes (PPROM) at 20 weeks and four days of gestation. She received cervical cerclage four days ago. Seven days after the diagnosis of PPROM, she developed fever, tachypnea and tachycardia. Termination of pregnancy was decided for clinical diagnosis of sepsis. After the abortus was born, gangrene change on the nose was noticed. Afterwards, this patient developed acrocyanosis of extremities. SPG developed following sepsis with intravascular disseminated coagulation (DIC). After intensive care, the patient underwent hyperbaric oxygen therapy and fasciectomy of the left forearm.

CONCLUSION

We suggest awareness of SPG associated with acute chorioamnionitis. Early recognition of SPG, multidisciplinary care, and treatment of its underlying conditions are the mainstays of management.

摘要

目的

对称性外周坏疽（SPG）是一种不常见但很重要的临床综合征。我们报告了一例急性绒毛膜羊膜炎并发 SPG 的病例。

病例报告

一名 33 岁女性（孕 5 产 2）因孕 20 周零 4 天胎膜早破（PPROM）入院。四天前她接受了宫颈环扎术。在诊断为 PPROM 七天后，她出现发热、呼吸急促和心动过速。因临床诊断为败血症，决定终止妊娠。在流产后，注意到鼻子出现坏疽改变。随后，该患者出现四肢发绀。在败血症伴血管内弥散性凝血（DIC）后发生 SPG。经过重症监护，患者接受高压氧治疗和左前臂筋膜切开术。