Kreshak Allyson A, Lawrence Shelley M, Ontiveros Sam T, Castellano Tiffany, VanHoesen Karen B
Division of Medical Toxicology, Department of Emergency Medicine, University of California San Diego, San Diego, California.
Division of Neonatal-Perinatal Medicine, University of Utah, Intermountain Health Care, Salt Lake City, Utah.
AJP Rep. 2022 Mar 9;12(1):e113-e116. doi: 10.1055/s-0042-1744216. eCollection 2022 Jan.
A 41-year-old gravida 4 para 3 (G4P3) and 38 weeks pregnant woman presented to labor and delivery with dizziness, headache, and decreased fetal movement after 12 hours of exposure to carbon monoxide (CO) from a grill that was used inside for heat. The mother was hemodynamically stable, and her neurologic examination was intact. Her carboxyhemoglobin level, which was obtained 12 hours after removal from the CO exposure, was 7.4%. The fetus's heart rate was 173 beats per minute with moderate variability and one late appearing deceleration, not associated with contractions. The biophysical profile score was 2 of 8. The obstetrics team performed a routine cesarean section. The 1- and 5-minute Apgar's scores were 7 and 8, respectively. The arterial cord gas result was as follows: pH = 7.05, PCO = 71 mm Hg, pO = 19 mm Hg, bicarbonate = 14 mmol/L, and carboxyhemoglobin = 11.9%. The mother and infant were treated with hyperbaric oxygen therapy consisting of 100% oxygen at 2.4 atmosphere absolutes (ATA) for 90 minutes at 2.5 hours after delivery. Following one hyperbaric oxygen treatment, the infant was transitioned to room air and routine postpartum treatment and was discharged 3 days later in good condition. Hyperbaric oxygen treatment was well tolerated in this neonate.
一名41岁、孕4产3（G4P3）、怀孕38周的妇女，在使用室内烤架取暖接触一氧化碳（CO）12小时后，出现头晕、头痛和胎动减少，前往分娩室就诊。母亲血流动力学稳定，神经系统检查正常。在脱离一氧化碳暴露12小时后测得其碳氧血红蛋白水平为7.4%。胎儿心率为每分钟173次，有中度变异，出现一次晚期减速，与宫缩无关。生物物理评分8分中的2分。产科团队进行了常规剖宫产。1分钟和5分钟阿氏评分分别为7分和8分。脐动脉血气结果如下：pH = 7.05，PCO = 71 mmHg，pO = 19 mmHg，碳酸氢盐 = 14 mmol/L，碳氧血红蛋白 = 11.9%。母亲和婴儿在分娩后2.5小时接受了高压氧治疗，即在2.4绝对大气压（ATA）下吸入100%氧气90分钟。经过一次高压氧治疗后，婴儿转为室内空气并接受常规产后治疗，3天后状况良好出院。该新生儿对高压氧治疗耐受性良好。
