Badehnoosh Bita, Hashemnejad Maryam, Mashak Banafsheh, Khoddami-Khosroshahi Mahya, Asemi Zatollah
Department of Gynecology and Obstetrics, Kamali hospital, Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Department of Gynecology and Obstetrics, Kamali hospital, Alborz University of Medical Sciences, Karaj, Iran.
Ann Med Surg (Lond). 2025 Apr 2;87(5):3012-3015. doi: 10.1097/MS9.0000000000003231. eCollection 2025 May.
An abdominal aortic aneurysm (AAA) is a localized dilatation of the infrarenal Aorta. The antiphospholipid syndrome (APS) is defined by the persistent presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity.
A 38-year-old woman, with a known case of APS, was referred to the emergency department three days after undergoing her second cesarean section. She presented with a 3-day history of fatigue and weakness with tachycardia and decreased blood pressure. Because of unstable hemodynamics, portable ultrasonography was performed and revealed intra-abdominal massive hematoma and free fluid with debris in the abdominal and pelvic spaces, the surgical team performed an exploratory laparotomy to assess the extent of the internal bleeding and to address the identified hematomas. A midline incision was performed for exploratory laparotomy, revealing a massive extraperitoneal hematoma in Zone 1 which ruptured immediately, not allowing the origin of the hematoma to be identified. Then cardiovascular collapse happened. Despite resuscitative efforts, including prolonged cardiopulmonary resuscitation for 30 minutes, the patient did not respond and was pronounced dead.
In this case, early detection of an AAA and prompt investigation might have enabled safer management of the pregnancy and cesarean section complications.
In this case, early detection of an AAA and prompt investigation might have enabled safer management of the pregnancy and cesarean section complications.
腹主动脉瘤（AAA）是肾下腹主动脉的局限性扩张。抗磷脂综合征（APS）的定义是，反复出现静脉或动脉血栓栓塞或妊娠并发症的患者持续存在抗磷脂抗体。
一名38岁女性，已知患有APS，在第二次剖宫产术后三天被转诊至急诊科。她出现了3天的疲劳和虚弱症状，伴有心动过速和血压下降。由于血流动力学不稳定，进行了便携式超声检查，发现腹腔内有大量血肿，腹腔和盆腔内有游离液体及碎屑，手术团队进行了剖腹探查，以评估内出血的程度并处理已发现的血肿。为进行剖腹探查做了正中切口，发现1区有巨大的腹膜外血肿，该血肿立即破裂，无法确定血肿的起源。随后发生了心血管衰竭。尽管进行了复苏努力，包括延长心肺复苏30分钟，但患者没有反应，最终被宣布死亡。
在本病例中，早期发现腹主动脉瘤并及时进行检查，可能会使妊娠和剖宫产并发症得到更安全的处理。
在本病例中，早期发现腹主动脉瘤并及时进行检查，可能会使妊娠和剖宫产并发症得到更安全的处理。
