摘要
目的 探讨与分析妊娠中晚期合并重症急性呼吸综合征 (SARS)患者的临床特点及母婴预后。方法 对我院 2 0 0 3年 2月 4日～ 3月 17日收治的妊娠中晚期合并SARS 5例患者的临床资料进行回顾性分析。结果 ( 1) 5例妊娠中晚期合并SARS(其中双胎妊娠 2例 )患者均为初产妇 ,孕中期发病 2例 ,孕晚期发病 3例 ;院内感染 3例 ,社区感染 2例。 ( 2 ) 5例患者均有发热 ( 5 / 5 ) ,其中高热 3例、低热 2例 ,畏寒或寒战 3例 ,咳嗽 4例。 ( 3)外周血淋巴细胞减少 2例 ,血小板减少 2例 ,肝酶升高3例 ,低蛋白血症 4例 ,X线胸片阴影 5例。 ( 4 ) 5例患者经对症治疗均已痊愈出院。 ( 5 )剖宫产 3例、阴道产 1例 ,共分娩新生儿 5例 (包括双胎 1例 ) ,新生儿随访至今无SARS感染。 1例双胎妊娠患者 ,一胎宫内死亡 ,另一胎儿现在观察中 ,情况尚稳定。结论 妊娠中晚期合并SARS患者的母婴预后尚好 ,但应注意妊娠期特殊的生理变化与SARS的相互影响。重症者宜适当放宽剖宫产指征 。
Objective To explore and analyze the clinical manifestation, diagnosis, management and maternal perinatal prognosis of severe acute respiratory syndrome (SARS) complicated pregnancy in second and third trimesters Methods Clinical data of 5 inpatients with SARS complicated pregnancy in second and third trimesters from 4 th February to 17 th March 2003 were analyzed retrospectively Results Five patients were all primigravida (including 2 twins).Two were infected in second trimester while the other 3 in third trimester with 2 hospital acquired infections and 3 community acquired infections. All patients had fever (5/5), 3 chills or rigor, 4 cough; 2 with decreased lymphocyte, 2 decreased platelet, 3 elevated alanine aminotransferase (ALT), 4 hypoalbuminemia, 5 abnormal chest radiographs. All 5 patients were cured with 1 requiring intensive care. 5 neonates including 1 twins have been followed up without evidence of SARS infections up to now. In a twin prgnancy 1 fetus was lost while the pregnant's situation is stable Conclusions Common diagnostic criteria were Suitable for SARS complicated pregnancy in second and third trimesters, but attention should be paid to the interaction between SARS and special pathological changes during pregnancy. Patients should be isolated and monitored intensively with timely cesarean section in severe cases, which could significantly decrease the maternal perinatal mortality. The use of corticosteroids and psychological supports need further study.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2003年第8期516-520,共5页
Chinese Journal of Obstetrics and Gynecology
