麻酔と蘇生 Volume 53 Issue 3
published_at 2017-09-20

帝王切開術中に発症した子宮型羊水塞栓症によると思われる産科DICの1例

A Case of Obstetrical DIC Probably Due to Uterine Type of Amniotic Fluid Embolism during Cesarean Section
Nakano Ayako
Yamagami Yuki
Sugawara Tomonori
Saita Masashi
Asaga Takehiko
Shirakami Gotaro
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AnesthResus_53-3_43.pdf
Abstract
A 42-year-old woman diagnosed as marginal placenta previa underwent cesarean section and bilateral tubal ligation under general anesthesia in 37th gestational week. Uterine contraction after delivery was good, but atonic bleeding progressed during tubal ligation. Oxytocic drugs were ineffective. We suspected obstetrical DIC and started treatment for DIC immediately, but the bleeding lasted. After total hysterectomy, she had stable vital signs. She broke away from DIC immediately after surgery. Intraoperative findings were satisfied the criteria for clinical uterine type amniotic fluid embolism (AFE). Although AFE indicates a bad prognosis, we saved her without any sequelae.
Keywords
羊水塞栓症
子宮型
DIC
帝王切開
Amniotic fluid embolism
Uterine type
DIC
Cesarean section