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两条生命危在旦夕:产科过敏性休克导致急性呼吸窘迫综合征——一例病例报告

Two lives at stake: Obstetric anaphylactic shock resulting in acute respiratory distress syndrome - A case report.

作者信息

Munasinghe B M, Perera R N, Kumara Skwr

机构信息

District General Hospital Mannar, Mannar, Sri Lanka.

出版信息

SAGE Open Med Case Rep. 2022 Mar 16;10:2050313X221084843. doi: 10.1177/2050313X221084843. eCollection 2022.

Abstract

Maternal anaphylaxis is rare albeit life-threatening critical incident dreaded by many due to negative effects on not only the mother but the foetus as well. Antibiotics and anaesthetic agents still contribute to majority of the episodes. Consequences of anaphylaxis such as placental insufficiency and subsequent foetal neurocognitive deficits are devastating outcomes. Acute respiratory distress syndrome following anaphylaxis is even rarer among the normal population. The management of maternal anaphylaxis does not differ from routine recommendations even though close monitoring and preparedness for early delivery should be embedded in the protocols. This is a rare case report of a primi mother who developed anaphylactic shock following intravenous penicillin in the background of negative allergic history, resultant foetal distress requiring emergency lower segment caesarian section and delayed onset acute respiratory distress syndrome which was later attributed to anaphylaxis. Pertinent identification and management which included a multidisciplinary team culminated in favourable outcomes.

摘要

尽管母体过敏反应很少见,但却是一种危及生命的严重事件,许多人对此感到恐惧,因为它不仅会对母亲产生负面影响,还会对胎儿产生影响。抗生素和麻醉剂仍是大多数此类事件的诱因。过敏反应的后果,如胎盘功能不全及随后的胎儿神经认知缺陷,都是毁灭性的结果。过敏反应后出现的急性呼吸窘迫综合征在普通人群中更为罕见。母体过敏反应的管理与常规建议并无不同,尽管方案中应包括密切监测和为早产做好准备。这是一例罕见的病例报告,一名初产妇在无过敏史的情况下静脉注射青霉素后发生过敏性休克,导致胎儿窘迫,需要紧急行下段剖宫产,随后出现延迟性急性呼吸窘迫综合征,后来被归因于过敏反应。包括多学科团队在内的相关识别和管理最终取得了良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/961e/8935580/57b6f333952f/10.1177_2050313X221084843-fig1.jpg

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