PDF(Pubmed)
Abstract：
Gas gangrene is a lethal necrotic infection resulting in gas production within tissue. It is typically associated with trauma and is especially lethal during pregnancy, resulting in severe maternal infection and fetal death. We report the case of a 31-year-old G3P2 female who presented to the emergency department with abdominal bloating, vaginal cramping, and brown vaginal discharge. Physical examination showed that the patient was hypertensive, tachycardic, and tachypneic, and laboratory examination showed a downtrending beta-human chorionic gonadotropin and leukocytosis, with elevated inflammatory markers. Ultrasound showed copious gas located within the lower abdomen and the fetus was not visualized. Computed tomography (CT) of the abdomen and pelvis showed a gravid uterus with a single fetus and extensive air locules in the fetus, amniotic cavity, and placenta. The findings were consistent with gas gangrene of a mature fetus in the third trimester. Fetal gas gangrene is a potentially lethal condition during pregnancy, and early diagnosis is imperative in management. CT was utilized in this case to outline the increased gas production within the amniotic cavity and fetal organs and proved crucial in determining the next steps of management.
摘要：
气体坏疽是一种致死性坏死感染，导致组织内产生气体。它通常与创伤有关，在怀孕期间尤其致命，导致严重的产妇感染和胎儿死亡。我们报告了一名31岁的G3P2女性，她因腹胀而被送往急诊科，阴道痉挛,和棕色的阴道分泌物.体检显示病人有高血压,心动过速,和快感，实验室检查显示β-人绒毛膜促性腺激素和白细胞增多呈下降趋势，炎症标志物升高。超声检查显示下腹部内有大量气体，未观察到胎儿。腹部和骨盆的计算机断层扫描（CT）显示妊娠子宫有一个胎儿，胎儿中有大量的空气室，羊膜腔,和胎盘。该发现与妊娠晚期成熟胎儿的气体坏疽一致。胎气坏疽是怀孕期间潜在的致命疾病，早期诊断在管理中势在必行。在这种情况下，CT被用来概述羊膜腔和胎儿器官内气体产生的增加，并被证明对确定下一步的管理至关重要。
