肌萎缩侧索硬化症合并妊娠一例并文献分析

Amyotrophic lateral sclerosis with pregnancy: a case report and literature review

目的研究肌萎缩侧索硬化症合并妊娠的临床特征及处理方法。方法回顾分析中山大学附属第一医院收治的1例及文献报道的13例肌萎缩侧索硬化症合并妊娠患者的临床表现、孕期处理及妊娠结局。结果 14例肌萎缩侧索硬化症合并妊娠患者,共有16例次分娩资料。临床表现主要为:6例呼吸功能不全,5例四肢肌无力,3例产后死于呼吸衰竭;分娩结果中有6例次早产,5例次足月分娩,1例次治疗性流产,另有4例次文献报道缺乏分娩孕周资料,所有病例均无因产科并发症而导致死亡。结论呼吸衰竭是导致肌萎缩侧索硬化症孕产妇死亡的主要原因,围产期需多学科合作,严密监护,及时处理相关并发症。

Objective To review and summarize the clinical features and treatment of amyotrophic lateral sclerosis in the pregnant women. Methods To studies the clinical manifestation, treatment and the outcome of 1 pregnancy woman with amyotrophic lateral sclerosis in the First Affiliated Hospital of Sun Yat-sen University and previous 13 literature reports. Results There were 14 cases of amyotrophie lateral sclerosis during pregnancy and 16 times deliveries. For clinical manifestation, 6 cases had respiratory insufficiency, 4 cases had weakness of limbs, and 3 cases died of respiratory failure after delivery. For the outcome of delivery, 6 cases were premature deliveries, 5 cases were term deliveries, and 1 case was therapeutic abortion. No cases died of obstetric complications. Conclusions Respiratory failure is the main cause of maternal mortality in pregnant women with amyotrophie lateral sclerosis. Multidisciplinary cooperation closed monitoring and treatments of complications in time are necessary in perinatal period.