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双胎妊娠中的母体感染

Maternal Infection with in Twin Pregnancy.

作者信息

Huang Pengzhu, Guo Xin, Duan Mengke, Li Huanrong, Han Cha, Xue Fengxia

机构信息

Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.

Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Apr 27;16:2511-2518. doi: 10.2147/IDR.S407244. eCollection 2023.

Abstract

is the conditional pathogenic bacteria, and pregnant women are at higher risk of infection due to depressed immunity. Infection with in twin pregnancy is rare but devastating, which puts forwards a great challenge for clinical management. Here, a 24-year-old woman was diagnosed with twin pregnancy, intrauterine death of one fetus and fever at 29 week of gestation. Two days later, she developed into pericardial effusion, pneumonedema and potential septic shock. The emergent cesarean delivery was performed after anti-shock treatment. One alive and another dead fetus were delivered. Then, she developed postpartum hemorrhage after the surgery. Urgent exploratory laparotomy was conducted at the sites of cesarean section and B-Lynch suture to stop bleeding. The culture of blood and maternal side of both placentas indicated . Following anti-infection therapy with ampicillin-sulbactam, she recovered well and discharged with negative result of blood bacterial culture and normal inflammatory indicators. The patient was hospitalized for a total of 18 days including 2 days in the intensive care unit (ICU), and the anti-infection treatment was conducted throughout the course. Symptoms of the infection in pregnancy are non-specific, which should be paid more attention in case of unexplained fever and fetal distress. The blood culture is effective for accurate diagnosis. infection is associated with poor pregnancy outcomes. Close monitoring of fetal condition, early intervention with antibiotics, timely termination of pregnancy and comprehensive management of complications are essential for better prognosis.

摘要

是条件致病菌,孕妇由于免疫力低下而感染风险更高。双胎妊娠感染 极为罕见但后果严重,这给临床管理带来了巨大挑战。在此,一名24岁女性在妊娠29周时被诊断为双胎妊娠,一胎儿宫内死亡且发热。两天后,她发展为心包积液、肺水肿和潜在的感染性休克。在抗休克治疗后进行了急诊剖宫产。娩出一活胎和一死胎。随后,她术后出现产后出血。在剖宫产部位进行了紧急剖腹探查并采用B-Lynch缝合法止血。血液及两个胎盘母体面的培养显示 。在使用氨苄西林-舒巴坦进行抗感染治疗后,她恢复良好,血细菌培养结果为阴性且炎症指标正常而出院。患者共住院18天,其中在重症监护病房(ICU)住了2天,且全程进行了抗感染治疗。孕期 感染的症状不具有特异性,在出现不明原因发热和胎儿窘迫时应予以更多关注。血培养对于准确诊断有效。 感染与不良妊娠结局相关。密切监测胎儿状况、早期使用抗生素干预、及时终止妊娠以及对并发症进行综合管理对于改善预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c9a/10150742/2d4fb390ea9f/IDR-16-2511-g0001.jpg

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