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Cardiac tamponade in pregnancy during central hyperalimentation
J S Greenspoon1, D I Masaki, C R Kurz
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Obstetrics and Gynecology
|March 1, 1989
Summary
Cardiac tamponade, a rare complication of central venous catheterization, occurred during pregnancy with total parenteral nutrition. This led to maternal cardiac arrest, brain death, and fetal demise despite resuscitation efforts.
Area of Science:
- Cardiology
- Obstetrics & Gynecology
- Critical Care Medicine
Background:
- Central venous catheterization is associated with a rare risk of cardiac tamponade.
- Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract.
- Hyperemesis gravidarum is severe nausea and vomiting during pregnancy.
Observation:
- This report details the first known case of cardiac tamponade linked to TPN in a pregnant patient.
- The complication occurred on the seventh day of central hyperalimentation for hyperemesis gravidarum.
- Cardiac tamponade led to cardiac arrest.
Findings:
- Maternal cardiopulmonary resuscitation was successful after pericardiocentesis.
- Despite resuscitation, the mother experienced brain death.
- Fetal death also occurred.
Implications:
- This case highlights unique diagnostic and therapeutic challenges of cardiac tamponade during pregnancy.
- It underscores the critical risks associated with central venous catheterization and TPN in obstetric patients.
- The findings emphasize the need for vigilant monitoring and prompt intervention in pregnant women receiving TPN.