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重度子痫前期产妇自发性肝破裂处理后的围手术期挑战——病例报告

Perioperative challenges following management of spontaneous hepatic rupture in a parturient with severe pre-eclampsia - A case report.

作者信息

Singh Keevan, Carvalho Randall, Tinne Allan, Bahall Vishal, De Barry Lance, Sankar Steven

机构信息

Department of Anaesthesia and Intensive Care, San Fernando General Hospital, Trinidad and Tobago.

Department of Surgery, San Fernando General Hospital, Trinidad and Tobago.

出版信息

Case Rep Womens Health. 2023 Mar 15;37:e00499. doi: 10.1016/j.crwh.2023.e00499. eCollection 2023 Mar.

Abstract

Spontaneous hepatic rupture in pregnancy (SHRP) is a rare but often fatal condition associated with pre-eclampsia or HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. SHRP is linked to significant maternal and perinatal morbidity and mortality, and maternal complications can extend past the initial intraoperative period. This case report describes the challenging perioperative course of a 35-year-old woman with SHRP. She underwent five laparotomies during a prolonged and complicated course in the intensive care unit. Despite these challenges, maternal and fetal outcomes were good. This case report serves to highlight key perioperative multidisciplinary issues in the care of these patients.

摘要

妊娠期自发性肝破裂(SHRP)是一种罕见但往往致命的疾病,与子痫前期或HELLP(溶血、肝酶升高、血小板减少)综合征相关。SHRP与严重的孕产妇和围产期发病率及死亡率有关,且孕产妇并发症可能会持续到初始手术期之后。本病例报告描述了一名患有SHRP的35岁女性具有挑战性的围手术期过程。在重症监护病房漫长而复杂的病程中,她接受了五次剖腹手术。尽管面临这些挑战,母婴结局良好。本病例报告旨在突出这些患者护理中关键的围手术期多学科问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aca/10033934/1878d9491b42/gr1.jpg

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