臨床外科75巻7号

2020年07月発行

特集 若手外科医必携！—緊急手術の適応と術式

妊婦に対する緊急手術の留意点

著者： 美坂聡樹¹ 百枝幹雄¹ 石松伸一²

所属機関： ¹聖路加国際病院 女性総合診療部 ²聖路加国際病院 救急部

ページ範囲：P.784 - P.788

【ポイント】
◆妊娠中の手術は十分な治療と妊娠の安全な継続という両者を考え，外科医，産婦人科医，麻酔科医，小児科医の間で十分協議することが大切となる．
◆術前の評価では，妊娠中の母体では特徴的な変化をきたしていること，妊娠中の画像検査の特徴，および患者へのカウンセリングに留意する．
◆手術時は妊娠週数，術者や施設の状況に応じ麻酔法や術式を選択し，胎児心拍数モニタリングも行う．
◆術後は十分な鎮痛と血栓予防を行い，切迫兆候がある場合は，産科と連携し子宮収縮抑制剤の使用を考慮する．

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