Snegovskikh Denis, Svokos Konstantina, Souza Dmitri, Renaud Elizabeth, Carr Stephen R, Kendall Mark C, Luks Francois I
Department of Anesthesiology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Department of Neurosurgery, Rhode Island Hospital, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Case Rep Anesthesiol. 2021 Mar 5;2021:6679845. doi: 10.1155/2021/6679845. eCollection 2021.
Effective tocolysis is essential after fetal myelomeningocele repair and is associated with the development of pulmonary edema. The increased uterine activity in the immediate postoperative period is commonly treated with magnesium sulfate. However, other tocolytic agents such as nitroglycerine, nifedipine, indomethacin, terbutaline, and atosiban (outside the US) have also been used to combat uterine contractility. The ideal tocolytic regimen which balances the risks and benefits of in-utero surgery has yet to be determined. In this case report, we describe a unique case of fetal myelomeningocele repair complicated by maternal pulmonary edema and increased uterine activity resistant to magnesium sulfate therapy.
胎儿脊髓脊膜膨出修补术后有效的宫缩抑制至关重要，且与肺水肿的发生有关。术后即刻子宫活动增加通常用硫酸镁治疗。然而，其他宫缩抑制剂如硝酸甘油、硝苯地平、吲哚美辛、特布他林和阿托西班（在美国境外）也被用于对抗子宫收缩。平衡宫内手术风险和益处的理想宫缩抑制方案尚未确定。在本病例报告中，我们描述了一例独特的胎儿脊髓脊膜膨出修补术病例，该病例并发母体肺水肿且对硫酸镁治疗耐药的子宫活动增加。
