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围产期新冠疫情背景下,一名早产的子痫前期产后婴儿出现类弥散性血管内凝血综合征。

DIC-like syndrome in a post-pre-eclampsia birth in a premature infant in a peri-COVID scenario.

作者信息

Hassan Taha F, Morgan Ryan D, Raghuram Akshay, Baronia Benedicto C

机构信息

School of Medicine, Texas Tech Health Sciences Center, Lubbock, TX, USA.

Surgery, Texas Tech Health Sciences Center University Medical Hospital, Lubbock, TX, USA.

出版信息

Case Rep Perinat Med. 2023 Oct 25;12(1):20230016. doi: 10.1515/crpm-2023-0016. eCollection 2023 Jan.

Abstract

OBJECTIVES

This article outlines an unusual presentation of a premature infant born from a pre-eclamptic mother born with a presentation resembling a disseminated intravascular coagulation syndrome.

CASE PRESENTATION

Pregnancy-induced hypertension, also known as pre-eclampsia, and premature birth pose significant risks to neonates, making the fetus more susceptible to immunodeficiencies and coagulopathies. This article highlights a premature infant born to a pre-eclamptic mother with multiple complications. Our case involved jaundice, neonatal meningitis, thrombocytopenia, leukopenia, neutropenia, hemorrhage, apnea, gastrointestinal defects, and periventricular leukomalacia. Often these complications are seen immediately after birth; these symptoms may present after a certain amount of time lapses if the neonates if afflicted with malignancy or a viral, fungal, or bacterial infection. Here we describe the case of a premature neonate born to a preeclamptic mother that experienced these complications one day after her birth.

CONCLUSIONS

This is the first known case of an infant experiencing a "DIC-like" syndrome without any diagnosis of a primary hematological malignancy or infection after a certain amount of time had lapsed since her birth. As complications in premature infants as well as those from pre-eclamptic mothers are common, this case report highlights a successful model of care. We also explore the effect of a peri-COVID setting on the presentation of this patient, as similar cases have occurred post-COVID-19.

摘要

目的

本文概述了一名早产婴儿的不寻常表现,该婴儿由患有先兆子痫的母亲所生,出生时表现类似弥散性血管内凝血综合征。

病例介绍

妊娠高血压综合征,也称为先兆子痫,以及早产对新生儿构成重大风险,使胎儿更容易出现免疫缺陷和凝血障碍。本文重点介绍了一名患有多种并发症的先兆子痫母亲所生的早产婴儿。我们的病例涉及黄疸、新生儿脑膜炎、血小板减少、白细胞减少、中性粒细胞减少、出血、呼吸暂停、胃肠道缺陷和脑室周围白质软化。这些并发症通常在出生后立即出现;如果新生儿患有恶性肿瘤或病毒、真菌或细菌感染,这些症状可能在一段时间后出现。在这里,我们描述了一名先兆子痫母亲所生的早产新生儿在出生一天后出现这些并发症的病例。

结论

这是已知的第一例婴儿在出生后一段时间后出现“类弥散性血管内凝血”综合征且未诊断出原发性血液系统恶性肿瘤或感染的病例。由于早产婴儿以及先兆子痫母亲所生婴儿的并发症很常见,本病例报告突出了一个成功的护理模式。我们还探讨了围新冠疫情环境对该患者表现的影响,因为在新冠疫情后也出现了类似病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9056/11616978/8c1215e9c1ef/j_crpm-2023-0016_fig_001.jpg

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