摘要
We report a case of a 25-year-old pregnant woman at 15 weeks and 4 days of gestation who presented with massive vaginal bleeding and syncope.She was diagnosed with incomplete spontaneous abortion,hemorrhagic shock,acute renal failure,and ketoacidosis.Emergency interventions included fluid resuscitation,blood transfusion,uterine evacuation,and continuous venovenous hemofiltration(CVVH).Due to septicemia,empirical anti-infective therapy with meropenem and vancomycin was initiated,guided by therapeutic drug monitoring(TDM)to optimize dosing.Over the course of treatment,the patient’s renal function improved,the infection was controlled,and she was stabilized and transferred to a general ward.This case highlights the challenges of managing sepsis and renal failure in pregnancy,emphasizing the critical role of TDM in optimizing antibiotic therapy.It underscores the importance of individualized treatment strategies in improving outcomes for high-risk pregnant patients and provides valuable insights for the management of similar cases.
