集中治療を必要とした周産期重症患者の検討

Abstract

The six cases of critically ill perinatal patients who have been cured in our intensive care unit during the past three years (April 1991-March 1994) were elucidated from the viewpoint of Intensive Care Medicine. Five patients were transferred to our hospital from other institutions. We have successfully treated the following critical conditions，including two patients who suffered from hemorrhagic shock due to postpartum bleeding，abruptio placenta and other causes ; pulmonary edema，HELLP syndrome (syndrome of hemolysis，elevated liver enzymes，and low platelet count)，eclampsia，eclampsia with HELLP syndrome. Obstetrical DIC scores of five patients were all more than 8，a severe degree score，when they arrived at ICU. Three patients required respiratory care with artificial ventilation and one patient was treated by mandatory oxygen inhalation. The patients suffering from hemorrhagic shock were intensively treated with blood transfusion，platelet-infusion and anticoagulation therapy ; also for the patients of eclampsia，anticoagulation therapy and vasodilation therapy were employed for hemodynamic stability. The patients with HELLP syndrome were given platelet infusion and liver supporting therapy ; diuretics were used for renal dysfunction. With aggressive care by co-medical staff in our ICU，all patients were discharged alive from ICU. In conclusion，intensive care should be applied to critically ill perinatal patients after definite diagnosis for avoidance of multiple organ failure.