目的探讨羊水栓塞的诊治经验,旨在提高羊水栓塞的抢救成功率。方法回顾性分析2004年1月-2014年1月我院诊治的羊水栓塞8例患者的临床资料。年龄18-44岁,平均（27.6±3.7）岁。孕周27-43周。其中初产妇1例,经产妇7例。所有AFE患者均...目的探讨羊水栓塞的诊治经验,旨在提高羊水栓塞的抢救成功率。方法回顾性分析2004年1月-2014年1月我院诊治的羊水栓塞8例患者的临床资料。年龄18-44岁,平均（27.6±3.7）岁。孕周27-43周。其中初产妇1例,经产妇7例。所有AFE患者均予以地塞米松20 mg静注,面罩加压给氧,开通多条静脉通道;对呼吸、循环系统症状明显者给予阿托品0.5-1.5 mg及氨茶碱250 mg,解除肺动脉高压。其中4例经上述处理后症状消失,余病情无缓解者继续给予地塞米松20 mg静脉注射,同时进行抗休克治疗。结果 8例AFE中,胎膜早破2例,使用催产素引产3例,剖宫产2例,其他1例。2例心肺复苏成功后未发生DIC。阴道出血量最少1000 m L,最多8000 m L,平均4500 m L。所有患者均存活,患者无一例出现羊水Ⅲ°粪染。结论羊水栓塞病情凶险,其治疗的三个重要方面是改善低氧血症、保持心输出量和血压、防止血管内凝血,要求临床医生要严格遵守医疗操作常规,努力提高产科技术,同时加强各科合作,才能提高抢救的成功率。展开更多
Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to ...Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnor展开更多
文摘目的探讨羊水栓塞的诊治经验,旨在提高羊水栓塞的抢救成功率。方法回顾性分析2004年1月-2014年1月我院诊治的羊水栓塞8例患者的临床资料。年龄18-44岁,平均（27.6±3.7）岁。孕周27-43周。其中初产妇1例,经产妇7例。所有AFE患者均予以地塞米松20 mg静注,面罩加压给氧,开通多条静脉通道;对呼吸、循环系统症状明显者给予阿托品0.5-1.5 mg及氨茶碱250 mg,解除肺动脉高压。其中4例经上述处理后症状消失,余病情无缓解者继续给予地塞米松20 mg静脉注射,同时进行抗休克治疗。结果 8例AFE中,胎膜早破2例,使用催产素引产3例,剖宫产2例,其他1例。2例心肺复苏成功后未发生DIC。阴道出血量最少1000 m L,最多8000 m L,平均4500 m L。所有患者均存活,患者无一例出现羊水Ⅲ°粪染。结论羊水栓塞病情凶险,其治疗的三个重要方面是改善低氧血症、保持心输出量和血压、防止血管内凝血,要求临床医生要严格遵守医疗操作常规,努力提高产科技术,同时加强各科合作,才能提高抢救的成功率。
文摘Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnor
