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Morbidly Obese Woman Unaware of Pregnancy until Full-Term and Complicated byIntraamniotic Sepsis with Pseudomonas

机译:病态肥胖的妇女直到足月才意识到怀孕并因羊膜内脓毒症与假单胞菌

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摘要

A 32-year-old Caucasian woman of body mass index (BMI) 46 presented with urinary symptoms to accident and emergency (A&E). Acute pyelonephritis was the diagnosis. Transabdominal scan revealed a live term fetus. Both the partners were unaware of the ongoing pregnancy until diagnosed. She underwent emergency cesarean under general anaesthesia (GA) for nonreassuring CTG, severe chorioamnionitis, and moderate preecclampsia. A live male baby weighing 4400 grams delivered in poor condition. Placental tissue on culture exhibited scanty growth of pseudomonas aeruginosa. Chorioamnionitis due to pseudomonas is rare, with high neonatal morbidity and mortality. It is mostly reported among preterm prelabor rupture of membranes (PPROM). Educating the community especially morbidly obese women if they put on excessive weight or with irregular periods should seek doctor's advice and exclude pregnancy. For the primary care provider, it is of great importance to exclude pregnancy in any reproductive woman presenting with abdominal complaints. This case also brings to clinicians notice that pseudomonas can be community-acquired and can affect term pregnancies with intact or prolonged rupture of membranes.
机译:一名体重指数(BMI)46的32岁白人妇女,表现出意外和急诊(A&E)的泌尿症状。诊断为急性肾盂肾炎。经腹扫描显示有活期胎儿。双方直到被诊断之前都没有意识到正在进行的怀孕。由于CTG不能令人放心,严重的绒毛膜羊膜炎和中度先兆子痫,她在全身麻醉(GA)下进行了紧急剖宫产。一个重达4400克的活男婴情况较差。培养的胎盘组织显示铜绿假单胞菌生长缓慢。由假单胞菌引起的绒毛膜羊膜炎很少见,具有较高的新生儿发病率和死亡率。早产儿胎膜早破(PPROM)的报道最多。对社区尤其是病态肥胖的妇女进行教育,如果她们过重或不规则的时期,应寻求医生的建议,并排除怀孕。对于初级保健提供者而言,排除任何有腹部不适的生殖妇女怀孕是非常重要的。这种情况也使临床医生注意到假单胞菌可以在社区获得,并且可以影响足月妊娠的胎膜完整或长时间破裂。

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