Towers C V, Pircon R A, Nageotte M P, Porto M, Garite T J
Department of Obstetrics and Gynecology, University of California, Irvine, Orange.
Obstet Gynecol. 1993 Apr;81(4):545-7.
To relate the clinical presentation of acute cocaine intoxication in the third trimester to preeclampsia and eclampsia.
Eleven women presented to Long Beach Memorial Women's Hospital and the University of California, Irvine Medical Center with hypertension and clinical symptoms of headache, blurred vision, abdominal pain, or seizures in the third trimester of pregnancy. Each had a positive urine drug screen for cocaine. The laboratory evaluation for preeclampsia included a complete blood count, platelet count, uric acid, aspartate aminotransferase, alanine aminotransferase, creatinine, and urine for protein content.
All women had a diastolic blood pressure of at least 90 mmHg, which returned to the normal range 45-90 minutes after admission. Each presented with one or more symptoms associated with preeclampsia, which ultimately improved as the drug wore off. In addition, all laboratory evaluations for preeclampsia were negative.
If a patient presents in the third trimester with hypertension and clinical symptoms of preeclampsia that rapidly improve shortly after admission, cocaine intoxication should be considered as the possible source.
探讨妊娠晚期急性可卡因中毒的临床表现与先兆子痫和子痫的关系。
11名女性在妊娠晚期因高血压以及头痛、视力模糊、腹痛或癫痫发作等临床症状就诊于长滩纪念妇女医院和加州大学欧文医学中心。她们的尿液药物筛查可卡因均呈阳性。先兆子痫的实验室评估包括全血细胞计数、血小板计数、尿酸、天冬氨酸转氨酶、丙氨酸转氨酶、肌酐以及尿蛋白含量检测。
所有女性舒张压均至少为90mmHg，入院后45 - 90分钟恢复至正常范围。她们均出现一种或多种与先兆子痫相关的症状，最终随着药物作用消退而改善。此外，所有先兆子痫的实验室评估均为阴性。
如果一名患者在妊娠晚期出现高血压及先兆子痫的临床症状，且入院后不久迅速改善，应考虑可卡因中毒为可能病因。
