Lewis D F, Chesson A L, Edwards M S, Weeks J W, Adair C D
Department of Obstetrics and Gynecology, Louisiana State University Medical Center, Shreveport 71130-3932, USA.
South Med J. 1998 Aug;91(8):761-2. doi: 10.1097/00007611-199808000-00013.
Obesity is known to increase maternal morbidity and mortality. We describe a case of obstructive sleep apnea due to obesity and discuss our treatment of the resulting pulmonary hypertension. A patient was transferred to our hospital at 29 weeks' gestation with severe anasarca and more than a 100-pound weight gain during pregnancy. Pulmonary hypertension due to obstructive sleep apnea was diagnosed. The patient was treated with nasal continuous positive airway pressure (CPAP) during sleep and remained in the hospital the remainder of her pregnancy. She had a massive spontaneous diuresis during her hospital stay and lost more than 100 pounds. She was delivered at term via cesarean section because of transverse lie. Preoperative hemodynamic monitoring confirmed the diagnosis of pulmonary hypertension. This represents the first case in the literature of obstructive sleep apnea leading to pulmonary hypertension in pregnancy. This patient responded well to nasal CPAP as evident by the massive diuresis and good maternal outcome.
众所周知，肥胖会增加孕产妇的发病率和死亡率。我们描述了一例因肥胖导致的阻塞性睡眠呼吸暂停病例，并讨论了我们对由此引发的肺动脉高压的治疗方法。一名患者在妊娠29周时因严重全身性水肿和孕期体重增加超过100磅被转至我院。诊断为阻塞性睡眠呼吸暂停所致的肺动脉高压。患者在睡眠期间接受经鼻持续气道正压通气（CPAP）治疗，并在孕期剩余时间一直住院。她在住院期间出现大量自发性利尿，体重减轻超过100磅。由于横位，她足月行剖宫产分娩。术前血流动力学监测确诊为肺动脉高压。这是文献中第一例阻塞性睡眠呼吸暂停导致妊娠期肺动脉高压的病例。大量利尿和良好的母婴结局表明该患者对经鼻CPAP治疗反应良好。
