重度子痫前期产前肺水肿1例,Journal of Obstetrics and Gynaecology

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重度子痫前期产前肺水肿1例
Journal of Obstetrics and Gynaecology ( IF 0.9 ) Pub Date : 2019-09-09 , DOI: 10.1080/01443615.2019.1645822
Vandna Verma ₁ , Abdul Hadi Waheed ₂ , Shazia Bhatti ₁ , Yves Van Roon ₃

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一名 34 岁的非洲裔初产妇，BMI 为 29.9kg/m，在妊娠 31±3 周时因新发的重度先兆子痫入院。她最初通过保守治疗有所改善，但 3 天后，她出现呼吸急促、端坐呼吸、上腹痛和呕吐，血压持续升高 160/100 mmHg，尽管有高血压。她被发现呼吸急促和心动过速，O2 饱和度下降到 94%。听诊显示基底音，胸部 X 光检查显示她有中度肺水肿。尽管对她的血压进行了适当的管理，她的呼吸功能还是恶化了，她的血液结果显示丙氨酸转氨酶 (ALT) 升高，血小板和肾功能正常。她的白蛋白水平为 23–24 g/L（参考范围：妊娠晚期 23–42 g/L，Abbassi-Ghanavati 等人。2009）。在全身麻醉下进行紧急剖腹产，出生了一个体重1885g的健康男婴，22天后他以良好的状态从NICU出院。母亲被转入重症监护室并维持机械插管 24 小时。产后母亲的肺水肿消退了。她的血液在第 12 天恢复正常，并在产后第 13 天服用药物出院回家。她在社区逐渐停用抗高血压药物，产后 6 周时，她在没有药物治疗的情况下血压正常。母亲被转入重症监护室并维持机械插管 24 小时。产后母亲的肺水肿消退了。她的血液在第 12 天恢复正常，并在产后第 13 天服用药物出院回家。她在社区逐渐停用抗高血压药物，产后 6 周时，她在没有药物治疗的情况下血压正常。母亲被转入重症监护室并维持机械插管 24 小时。产后母亲的肺水肿消退了。她的血液在第 12 天恢复正常，并在产后第 13 天服药出院。她在社区逐渐停用抗高血压药物，产后 6 周时，她在没有药物治疗的情况下血压正常。

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A case of antepartum pulmonary oedema complicating severe preeclampsia

A 34-year-old primigravida of African origin with a BMI of 29.9kg/m, was admitted with new onset severe preeclampsia at 31þ 3 weeks of gestation. She improved initially on conservative treatment but, three days later, she developed shortness of breath with orthopnoea, epigastric pain and vomiting with persistently raised BP of 160/100mmHg, despite hypertensives. She was found to be tachypnoeic and tachycardic and O2 saturations dropped to 94%. Auscultation revealed basal crepitations and a chest X-Ray showed she had a moderate pulmonary oedema. Despite appropriate management of her blood pressure, her respiratory function deteriorated and her blood results showed a rising alanine transaminase (ALT) with normal platelets and renal function. Her albumin levels were 23–24 g/L (reference range: 23–42 g/ L in the third trimester, Abbassi-Ghanavati et al. 2009). An emergency caesarean section was performed under a general anaesthesia and a live healthy male baby weighing 1885g was born, who was discharged from NICU after 22 days in a good condition. The mother was transferred to the intensive care unit and was maintained on mechanical intubation for 24 h. The mother’s pulmonary oedema resolved postpartum. Her bloods normalised by day 12 and she was discharged home on day 13 postpartum on medication. She was gradually weaned off antihypertensives in the community and at 6 weeks postpartum, she was normotensive without medication.

更新日期：2019-09-09

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