[Pathophysiological and therapeutic aspects of XXXX (anaphylactoid syndrome of pregnancy): case report with lethal outcome and overview].

@entity1 @entity101 @entity548 @entity326 @entity1457 @entity2102 @entity147 @entity1151 @entity177 @entity5642 @entity397 @entity1468 @entity6703 @entity881 @entity2661 @entity2021
A 35-years old gravida IV and para II underwent caesarean section because of @entity147 following induction of labour. During operation the @entity1 developed @entity5642 ( @entity5642 ), severe @entity548 and @entity1457 necessitating massive blood transfusion,hysterectomy with pelvic packing, and high-dose @entity2661 . Ultimately, recombinant factor VIIa was given to control @entity548 . During the first 24 hours after operation, both clinical and laboratory findings showed that the severe @entity5642 was on the course to recovery.However, the @entity1 subsequently developed @entity881 with respiratory and @entity177 requiring mechanical ventilation and haemodialysis.All therapeutical efforts could not help that the @entity1 passed away due to an inevitable @entity881 on the 12th day after the operation. Given the constellation of diagnostic and clinical findings, the most likely diagnosis was @entity6703 ( @entity6703 ), a rare complication of pregnancy. The following differential diagnoses were less likely or excluded in this reported @entity1 : @entity1468 /pregnancy-induced @entity101 , @entity2102 , @entity2021 ,uterine @entity397 , transfusion reactions, @entity1151 . @entity6703 occurs rarely, and because studies in animal models cannot reproduce accurately the pathophysiological and clinical alterations seen in @entity1 , its pathogenesis remains unclear. It has been proposed that the clinical syndrome of @entity6703 occurs when fetal antigens pass the maternal immunological barrier in susceptible mothers. The recognition of fetal antigens by maternal immune system subsequently triggers the release of endogenous mediators that are responsible for dramatic pathophysiological disturbances.Furthermore, the components of amniotic fluid initiate the @entity5642 . These events are more consistent with @entity326 and anaphylactic @entity1457 than with an embolic process and it was proposed that the term " @entity6703 " be changed to "anaphylactoid syndrome of pregnancy". At present, no therapy has been found to consistently improve outcomes in @entity1 with @entity6703 . @entity1 who survive the initial insult are at high risk for @entity881 . The mortality of @entity6703 remains high.
