A case of fat embolism syndrome during pregnancy.

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This is the first case report of fat embolism syndrome during pregnancy. A 31-year-old female, 30 weeks' gestation, para 1, was admitted with left femoral shaft fracture due to a traffic accident. Her left femur was fixed with direct traction, and ritodrine 100μg/min was administered for uterine tocolysis. Two days later respiratory distress and delirium appeared, and her chest roentgenograms showed bilateral diffuse infiltrations. She underwent cesarian section because of severe hypoxemia (PaO2/FiO2 ; 85mmHg) and a critical condition. Her respiration was controlled with synchronized intermittent mandatory ventilation (SIMV) with positive endo-expiratory pressure (PEEP) for 4 days after the cesarean section. Respiratory control and the prevention of DIC are important in treating fat embolism syndrome. The mother's life was saved but the baby (1790 g, Apg.4/7) died shortly after cesarian section despite almost normal FHB monitoring just before the operation. There is a strong suspicion of fat emboli in the placenta and new born lung. Termination of pregnancy should be considered when there is life threatening hypoxemia, which is one of the major signs of fat embolism syndrome. [Adv Obster Gynecol 46(2) : 200-207, 1994 (H6.3)]
近畿産科婦人科学会の論文