- 期刊
Sepsis and Septic Shock following Pneumonia in Pregnancy may Cause Adverse Pregnant Outcome
妊娠肺炎所引發之敗血症及敗血性休克可能會導致不良懷孕結果
摘要
目的：本研究之目的在於評估妊娠肺炎對臨床病程與懷孕結果之影響。材料和方法：在1995至2001年間，我們從馬偕紀念醫院之病例檔案中收集了十三位妊娠期間患有肺炎之案例。這些孕婦之臨床表現，年齡，妊娠週數，危險因子，臨床病程，放射線檢查之結果，實驗室檢查之數據，治療過程與懷孕結果，皆由病例紀錄得到完整之資料。 結果：有三位孕婦在肺炎發生後併發敗血症及敗血性休克，而且皆有不良之懷孕結果，包括一例在妊娠三十週早產：一例在妊娠二十三週發現胎死腹中；另一例在妊娠二十七週因早期破水而接受中止妊娠。上述三各案例雖然在重症照護下並無孕婦死亡，卻還是有不良之懷孕結果產生。其餘十個案例，皆能成功的在足月生產，且無不良之預後。 結論：我們觀察到妊娠肺炎若合併有敗血症或敗血性休克，則很可能會導致不良之懷孕結果。若能夠預防且提早發現呼吸道感染疾病，並給予積極的治療，應可以減少不良懷孕結果之發生。
並列摘要
Objective: To determine the clinical course and pregnant outcome of women with pneumonia in pregnancy. Material(s) and Method(s): Between 1995 and 2001, we collected thirteen cases of pregnancy with pneumonia from computerized database of Mackay Memorial Hospital. The clinical features, maternal age, gestational age, risk factors, clinical courses, radiographic findings, treatment, laboratory data, and the pregnancy outcomes were reviewed by medical records. Result(s): There were three women complicated with sepsis and septic shock, and all of them had adverse pregnancy outcome, including one preterm labor at 30 weeks’ gestation, one intrauterine fetal death at 23 weeks’ gestation and one termination of pregnancy due to preterm premature rupture of membrane at 27 weeks’ gestation. All these three women underwent intensive care without maternal mortality. The other ten cases were able to achieve term pregnancy without any adverse outcome. Conclusion(s): Our observations show that when pneumonia in pregnancy complicated with sepsis and septic shock, adverse pregnancy outcome should be considered. Adverse pregnant outcomes can be minimized by preventive measurements, early recognition and aggresive treatment of the pulmonary illness.