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成功保守治疗妊娠晚期单侧自发性肾上腺出血导致严重贫血的病例报告。

Successful Conservative Treatment of Maternal Spontaneous Unilateral Adrenal Hemorrhage Causing Severe Anemia in the Third Trimester of Pregnancy-A Case Report.

机构信息

Department of General and Oncological Surgery, Pomeranian Medical University, 70-111 Szczecin, Poland.

Department of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin, 72-010 Police, Poland.

出版信息

Medicina (Kaunas). 2024 Sep 4;60(9):1448. doi: 10.3390/medicina60091448.

Abstract

We present the case of a 32-year-old pregnant woman in the 32 + 3 weeks of pregnancy who presented to the hospital with an exacerbation of pain in the right flank. The diagnostic evaluation revealed the presence of severe anemia and a spontaneous adrenal hemorrhage (SAH) in the right adrenal gland. The patient was transferred to the Perinatology, Obstetrics and Gynecology Clinic with the intention of undergoing preterm childbirth. However, the doctors made a risky decision to wait until week 37 and to terminate the pregnancy at that point. The decision was right, as a cesarean section was performed without complications, and the patient gave birth to a healthy child. Spontaneous adrenal hemorrhage (SAH) is a rare condition, defined as spontaneous hemorrhage without trauma or anticoagulant therapy. Due to bleeding and damage to the adrenal cortex, SAH can lead to adrenal insufficiency. Because of its non-specific symptoms and potentially fatal outcomes for the patient and fetus, it should be considered during diagnostics.

摘要

我们报告了一例 32 岁孕妇,妊娠 32+3 周,因右侧腰部疼痛加重就诊。诊断评估显示严重贫血和右侧肾上腺自发性肾上腺出血(SAH)。患者被转至围产、产科和妇科诊所,拟行早产。然而,医生做出了一个冒险的决定,等待至 37 周并在该时点终止妊娠。该决定是正确的,因为患者行剖宫产术,无并发症,且分娩出一健康婴儿。自发性肾上腺出血(SAH)是一种罕见的情况,定义为无创伤或抗凝治疗的自发性出血。由于出血和肾上腺皮质损伤,SAH 可导致肾上腺功能不全。由于其症状不典型且对患者和胎儿可能有致命后果,应在诊断过程中考虑到。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6627/11434074/e8495177eb89/medicina-60-01448-g001.jpg

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