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[A case report of a successfully rescued patient with respiratory failure in late pregnancy]
Wen-yong Han1, Yang-yu Zhao, Xi Zhu
1Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China. tfhan@126.com
Respiratory problem is a common concomitant disease during pregnancy. Puerpera with respiratory failure has a high risk of morbidity and mortality. During pregnancy, a puerpera usually experienced obvious respiratory changes, which make the mother carry out enough oxygen to provide the fetus and meet its increasing need, and ensure that the mother will remove the excess of carbon dioxide produced by the elevated metabolic demands as the fetus grows mature. The normal value of arterial carbon dioxide tension(PaCO2 )is around 28 to 34 mmHg during noncomplicated pregnancies. The case we reported here was a 26-year-old woman, with G1P0. Emergency admission to Peking University Third Hospital because of chest suffocating for about 6 months. She was diagnosed as "Intrauterine pregnancy over 34 weeks, with respiratory failure type II and acidosis". The PaCO2 of the puerpera reached 74 mmHg before delivery and 94 mmHg after delivery. The doctors from several departments conducted cooperative management, undertook combined spinal and epidural anesthesia in the sitting position, controlled the anesthesia level and applied low concentration oxygen therapy. The baby was delivered successfully and the mother's condition was kept stable. Both the mother and the baby were discharged safely 11 days after operation. Although we carried out a series of checks, the exact cause of the disease remained unclear.
Respiratory problem is a common concomitant disease during pregnancy. Puerpera with respiratory failure has a high risk of morbidity and mortality. During pregnancy, a puerpera usually experienced obvious respiratory changes, which make the mother carry out enough oxygen to provide the fetus and meet its increasing need, and ensure that the mother will remove the excess of carbon dioxide produced by the elevated metabolic demands as the fetus grows mature. The normal value of arterial carbon dioxide tension(PaCO2 )is around 28 to 34 mmHg during noncomplicated pregnancies. The case we reported here was a 26-year-old woman, with G1P0. Emergency admission to Peking University Third Hospital because of chest suffocating for about 6 months. She was diagnosed as "Intrauterine pregnancy over 34 weeks, with respiratory failure type II and acidosis". The PaCO2 of the puerpera reached 74 mmHg before delivery and 94 mmHg after delivery. The doctors from several departments conducted cooperative management, undertook combined spinal and epidural anesthesia in the sitting position, controlled the anesthesia level and applied low concentration oxygen therapy. The baby was delivered successfully and the mother's condition was kept stable. Both the mother and the baby were discharged safely 11 days after operation. Although we carried out a series of checks, the exact cause of the disease remained unclear.
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