Hankins G D, Wendel G D, Snyder R R, Cunningham F G
Obstet Gynecol. 1987 Mar;69(3 Pt 1):368-72.
We evaluated prospectively the extent of trophoblastic embolization and its central hemodynamic effects during and after evacuation of large molar pregnancies in six women. A pulmonary artery catheter was inserted to obtain hemodynamic measurements as well as to obtain blood samples to identify trophoblasts before, during, and six hours after evacuation. Small numbers of both multinucleated giant cells and of large mononuclear cells with abundant cytoplasm were identified in the buffy coat of blood, aspirated in two cases before evacuation and for all six cases, during evacuation. There were no significant changes in heart rate or mean systemic arterial, pulmonary arterial, central venous, and pulmonary capillary wedge pressures; or cardiac output, stroke volume, and pulmonary or systemic vascular resistance when preevacuation preanesthetic values were compared with those six hours after evacuation. However, significant decreases in heart rate, mean arterial pressure, and pulmonary vascular resistance were observed during evacuation, which returned to preevacuation levels by completion of anesthesia.
我们前瞻性地评估了6名妇女在大葡萄胎妊娠清宫术中及术后滋养层细胞栓塞的程度及其对中心血流动力学的影响。在清宫术前、术中及术后6小时插入肺动脉导管，以获取血流动力学测量数据，并采集血样以识别滋养层细胞。在两例清宫术前及所有6例清宫术中抽取的血液中，在血沉棕黄层中发现了少量多核巨细胞和大量富含细胞质的大单核细胞。将麻醉前清宫前的值与清宫后6小时的值进行比较时，心率、平均体动脉压、肺动脉压、中心静脉压和肺毛细血管楔压；或心输出量、每搏输出量以及肺或体循环血管阻力均无显著变化。然而，在清宫术中观察到心率、平均动脉压和肺血管阻力显著下降，在麻醉结束时恢复到清宫前水平。
