Ewing T L, Smale L E, Elliott F A
Am J Obstet Gynecol. 1979 May 15;134(2):173-9. doi: 10.1016/0002-9378(79)90882-2.
Reported are three maternal deaths in four patients who presented with a similar syndrome following a normal antepartum course and normal labor and delivery managed by regional or local anesthesia and midline or proctoepisiotomy. Beginning about the second postpartum day, the patients developed unilateral perineal edema and induration which progressed to generalized vulvar, vaginal, perineal, and gluteal edema and induration. These patients developed marked leukocytosis, fever, and ultimately vascular collapse; three of them died. The one patient who survived had a similar course except for vascular collapse. Unilateral vulvar induration and edema associated with fever and marked leukocytosis are ominous signs. Aggressive treatment should include the use of multiple antibiotic, crystaloid, colloid, and steroid drugs and appropriate monitoring. By this report we hope to bring attention to this rare but lethal syndrome.
据报道，4例患者中有3例产妇死亡，这些患者在正常产前过程、正常分娩且由区域或局部麻醉以及会阴正中切开术或会阴侧斜切开术处理后，出现了类似综合征。大约在产后第二天开始，患者出现单侧会阴水肿和硬结，进而发展为广泛的外阴、阴道、会阴和臀部水肿及硬结。这些患者出现了明显的白细胞增多、发热，并最终发生血管性虚脱；其中3例死亡。存活的1例患者除未发生血管性虚脱外，病程相似。单侧外阴硬结和水肿伴发热及明显的白细胞增多是不祥之兆。积极的治疗应包括使用多种抗生素、晶体液、胶体液和类固醇药物以及适当的监测。通过本报告，我们希望引起对这种罕见但致命综合征的关注。
