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介入放射学在羊水栓塞管理中的突破:一例报告

Breaking Barriers in the Management of Amniotic Fluid Embolism With Interventional Radiology: A Case Report.

作者信息

Sun Amber W, Barua Priya, Benton Alexander, Do Brian

机构信息

Department of Radiology, University of Missouri - Kansas City (UMKC) School of Medicine, Kansas City, USA.

Department of Obstetrics and Gynecology, University of Missouri - Kansas City (UMKC) School of Medicine, Kansas City, USA.

出版信息

Cureus. 2024 Aug 26;16(8):e67821. doi: 10.7759/cureus.67821. eCollection 2024 Aug.

Abstract

Amniotic fluid embolism (AFE) is a rare obstetric emergency with a high mortality rate despite treatment. The pathogenesis likely involves inflammatory cytokines reacting to amniotic fluid in the bloodstream, causing rapid multi-organ failure and coagulopathy. Prompt recognition and supportive, multidisciplinary treatment are vital for enhancing patient outcomes. This report presents the case of a 27-year-old female with acute decompensation due to AFE. Our patient was scheduled for cesarean delivery due to high-risk placental anomalies and began demonstrating signs of AFE and severe hemorrhage shortly after delivery. She was transferred to our tertiary care center and was treated with coil embolization of the hemorrhaging uterine, iliac, and epigastric arteries, ultimately stabilizing her and saving her life. This case highlights the successful management of AFE with interventional radiological (IR) techniques.

摘要

羊水栓塞(AFE)是一种罕见的产科急症,尽管进行了治疗,死亡率仍很高。其发病机制可能涉及炎性细胞因子对血液中羊水的反应,导致快速的多器官功能衰竭和凝血病。迅速识别并给予支持性的多学科治疗对于改善患者预后至关重要。本报告介绍了一名27岁因羊水栓塞导致急性失代偿的女性病例。我们的患者因高危胎盘异常计划行剖宫产,产后不久即开始出现羊水栓塞和严重出血的迹象。她被转至我们的三级医疗中心,接受了出血的子宫、髂动脉和腹壁动脉的线圈栓塞治疗,最终病情稳定并挽救了生命。本病例突出了采用介入放射学(IR)技术成功治疗羊水栓塞的经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e34/11346806/744659543fe0/cureus-0016-00000067821-i01.jpg

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