Downs T W, Chao C R
Harbor UCLA Medical Center, Torrance, USA.
Am J Perinatol. 1997 Jan;14(1):51-3. doi: 10.1055/s-2007-994096.
Massive hemoptysis is a life-threatening situation that rarely complicates pregnancy. Presented is a case of massive hemoptysis during pregnancy, which was successfully diagnosed and treated with bronchial artery angiogram and embolization. A 26-year-old multigravida at 19 weeks' gestational age with a history of intravenous substance abuse and infective endocarditis presented with hemoptysis. Extensive workup, including bronchoscopy, echocardiography, and magnetic resonance pulmonary angiography were negative. The patient left the hospital against medical advice to return 4 weeks later with massive hemoptysis. Bronchial arteriography revealed multiple areas of potential bleeding in the right and left lower lobes. Bilateral bronchial artery embolization was performed. The patient carried the pregnancy to term with no further episodes of hemoptysis. Hemoptysis during pregnancy requires a thorough workup and prompt treatment if the etiology is diagnosed. When faced with massive hemoptysis, the obstetrician should strongly consider bronchial artery angiography and embolization.
大量咯血是一种危及生命的情况，在妊娠期间很少出现并发症。本文介绍了一例妊娠期间大量咯血的病例，该病例通过支气管动脉血管造影和栓塞术成功诊断并得到治疗。一名26岁、孕19周的经产妇，有静脉药物滥用和感染性心内膜炎病史，出现咯血症状。包括支气管镜检查、超声心动图和磁共振肺血管造影在内的全面检查均为阴性。患者不顾医嘱离院，4周后因大量咯血再次前来就诊。支气管动脉造影显示左右下叶有多个潜在出血区域。遂进行了双侧支气管动脉栓塞术。患者妊娠至足月，未再出现咯血情况。妊娠期间的咯血需要进行全面检查，若病因明确则应及时治疗。面对大量咯血时，产科医生应强烈考虑支气管动脉血管造影和栓塞术。
