Birnbach D J, Bourlier R A, Choi R, Thys D M
Department of Anesthesiology, St Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons of Columbia University, New York, New York 10019, USA.
Br J Anaesth. 1995 Nov;75(5):639-41. doi: 10.1093/bja/75.5.639.
We report the anaesthetic management of a pregnant patient with multiple manifestations of HIV infection who underwent Caesarean section. A 30-yr-old, HIV-positive, Haitian woman presented with acute psychosis at 28 weeks' gestation. A diagnosis of HIV dementia complex was made and haloperidol therapy was started. Five days after admission the patient was found to be in labour and tocolytic therapy with terbutaline was commenced. A vaginal lesion compatible with herpes simplex virus was observed which was treated with acyclovir. After 3 days of tocolytic therapy there were no further signs of preterm labour. Two weeks later, at 30 weeks' gestation, the patient's membranes ruptured spontaneously. The herpes labialis lesion was still present and urgent Caesarean section was begun using subarachnoid 0.75% bupivacaine 1.5 ml. The patient had no intraoperative problems and a 1700-g healthy male child was delivered.
我们报告了一例接受剖宫产的感染人类免疫缺陷病毒（HIV）且有多种临床表现的孕妇的麻醉管理情况。一名30岁的HIV阳性海地女性，在妊娠28周时出现急性精神病症状。诊断为HIV痴呆综合征，并开始使用氟哌啶醇治疗。入院五天后，发现患者正在分娩，遂开始用特布他林进行宫缩抑制治疗。观察到一处与单纯疱疹病毒相符的阴道病变，用阿昔洛韦进行了治疗。宫缩抑制治疗三天后，未再出现早产迹象。两周后，妊娠30周时，患者胎膜自发破裂。唇疱疹病变仍然存在，遂紧急行剖宫产，蛛网膜下腔注射0.75%布比卡因1.5毫升。患者术中无问题，产下一名体重1700克的健康男婴。
