1 case of cesarean section complicated by amniotic fluid embolism.docVIP

 PAGE \* MERGEFORMAT 5 1 case of cesarean section complicated by amniotic fluid embolism 1 Case Report Patients aged 42, hospital No. 015 520. Because G2P1, 41 +2 weeks menopause, prenatal clinics found that fetal heart rate Pianman (120 beats / min, 2 hours after the February 23, 2010 the morning of the “fetal distress” hospital stay . past physical health of patients, no special medical history, the first births in 18 years (birth, last menstrual period May 7, 2009, into the admission examination: T36.5 , P80 times / min, R20 times / min , BP108/80mmHg, heart, lung, abdominal examination were normal. obstetric examination: Temple High 37cm, abdominal circumference 93cm, ROA, fetal heart tones of 120 beats / min, first exposed the high float, no rupture of membranes, no contractions, NST comments 8 points, B-ultrasonic examination: fetal biparietal diameter 9.5cm, femur length 7. 4cm, amniotic fluid index of 8.5, suggesting that amniotic fluid turbidity, placental maturity degrees. laboratory: WBC10.1 10 9 / L, N64. 4%, RBC3.20 10 12 / L, Hb111g / L, PLT231.0 10 9 / L, normal coagulation, liver and kidney function is normal, into surgery at 14:00 that afternoon Room cesarean section, cuts out a live baby boy (weight 3.7kg cloudy amniotic fluid, smooth operation, suturing the skin, the patient complained abdominal pain, irritability, BP60/30mmHg, consider the “amniotic fluid embolism” may, immediately increase the intravenous access, intravenous injection of hydrochloric acid poppy theophylline, dexamethasone, atropine, aminophylline, speed up the rate of infusion, the patient subsequently pale, clear mind is still, of surgery vaginal bleeding, BP40/20mmHg, search blood, WBC12.9 10 9 / L, N88. 7%, RBC1.9 1012 / L, Hb518g / L, the results of coagulation, thrombin time prolonged, decreased fibrinogen, 3P test ( +, amniotic fluid embolism diagnosis was established, that is, enter red blood cells with blood, plasma, platelets, coagulation precipit