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患者女,37岁,G_3P_2宫内孕43周入院。查生命体征正常,胎心140次/分,胎头高浮,腹围98cm,宫高36cm,无宫缩。予静脉点滴催产素终止妊娠,8滴/分无宫缩,30分钟后调至14滴/分,仍无宫缩,即认为对催产素作用不敏感,加快至30滴/分,数分钟后出现宫缩且自然破水。破水后病入突然烦躁不安,大汗淋漓,胸闷气短,全身絮绀,测血压零,脉搏不清,心率160次/分,诊断为羊水栓塞。立即停输催产素,吸氧、强心扩血管、抗休克等治疗后症状绥解。测血压12.0/6.67kPa,脉搏120次/分,胎心150次/分,宫口开大3cm,待胎儿娩出后又发生阴道大出血,肌注催产素30u无效,测血压6.67/0kPa,脉搏细弱,立即新鲜血,抗纤溶治疗法后,病情好转。讨论:羊水栓塞是产科一种少见而凶险的并发症.死亡率高达80％以上。本例考虑由于点滴催产素速度过快致宫缩加强,使羊膜腔内压力超过静脉
Female patient, 37 years old, G_3P_2 intrauterine pregnancy 43 weeks admitted. Check the normal signs of life, fetal heart rate 140 beats / min, fetal head floating high, abdominal circumference 98cm, Palace 36cm high, no contractions. Intravenous oxytocin intravenous termination, 8 drops / min without contractions, 30 minutes after the transfer to 14 drops / min, still no contractions, that is not sensitive to the role of oxytocin, accelerated to 30 drops / min, a few minutes later Contractions and natural water break. Sudden irritability after breaking water, sweating, chest tightness, shortness of breath, systemic cyanosis, measuring blood pressure zero, pulse is not clear, heart rate 160 beats / min, diagnosis of amniotic fluid embolism. Immediately stop oxytocin, oxygen, cardiac vasodilation, anti-shock and other symptoms after treatment. Blood pressure 12.0 / 6.67kPa, pulse 120 beats / min, fetal heart rate 150 beats / min, cervix open 3cm, to be fetus after vaginal bleeding again, intramuscular oxytocin 30u invalid, blood pressure 6.67 / 0kPa, pulse weak , Immediately new blood, anti-fibrinolytic therapy, the condition improved. Discussion: Amniotic fluid embolism is a rare and dangerous complication of obstetrics with a mortality rate of up to 80%. In this case, due to the rapid drip oxytocin caused by contractions to enhance the pressure in the amniotic cavity over the veins