RESUMEN
Abstract Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient.
Resumo Dexmedetomidina é um α2-agonista altamente seletivo que recentemente revolucionou a nossa prática de anestesia e tratamento intensivo. Uma paciente obstétrica foi admitida para cesariana de emergência sob anestesia geral, com pré-eclâmpsia e hemorragia pós-parto. Em casos cuidadosamente selecionados com hipertensão refratária e hemorragia pós-parto, dexmedetomidina pode ser usada para melhorar o resultado geral da paciente. O fármaco foi benéfico no controle tanto da pressão arterial quanto do sangramento uterino durante cesariana em nossa paciente.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Analgésicos no Narcóticos/uso terapéutico , Dexmedetomidina/uso terapéutico , Hipertensión Inducida en el Embarazo , Hemorragia Posparto/etiología , Anestesia Obstétrica , Cesárea/métodos , Tratamiento de UrgenciaRESUMEN
Objective To investigate the influence of forceps delivery or emergency cesarean section on the maternal and infant outcome in pregnant women with abnormal second stage of labor.Methods We retrospectively analyzed the clinical data of 118 parturients with abnormal second stage of labor in the department of obstetrics and gynecology in our hospital from 2013 January to 2015 February.The involved parturients with abnormal second stage of labor received different delivery modes including forceps delivery and emergency cesarean section, and the delivery time and its influence on the maternal and infant outcome were compared.Results The mean delivery time of forceps delivery and emergency cesarean section was (14.8 ± 5.3) and (32.7 ± 12.6) minutes, the difference was significant (P＜0.05).The bleeding probability and the occurrence of severe neonatal asphyxia in the forceps delivery group was obviously lower than that of maternal emergency cesarean section group (P＜0.05).The influence of emergency cesarean section on the newborn severe asphyxia was more serious than forceps delivery (P ＜0.05).There was no statistical difference in the mild asphyxia, facial bruising, scalp hematoma and neonatal pneumonia between the two groups.Conclusion Compared with emergency cesarean section, forceps delivery can protect the safety of mother and child can reduce dystocia risk coefficient for the pregnant women with abnormal second stage of labor.
RESUMEN
A 36 year old woman, at 37 week gestation, had admitted to our Obstetric-Gynecology department. On her admission, she complained mild fever, neck pain and severe hoarsness. Laboratory test demonstrated increased level of activated partial thromboplastin time 40.2 second(control 26), aspartate aminotransferase 685 IU/L(normal range 10~50), alanine aminotransferase 404 IU/L(normal range 5~45). The diagnosis, acute fatty liver of pregnancy was made by ultrasound of the liver and clinical and laboratory findings. Also the diagnosis, acute laryngitis was made by laryngoscopic and clinical and laboratory findings. On her 3rd day of admission, she complained labor pain. An emergency cesarean section was performed under spinal anesthesia. After delivery, her postoperative prognosis was uneventful, and she discharged from the hospital on postoperative 8th days.