[Gastro-duodenal ulcers with pregnancy. Condition of shock in labour due to intestinal haemorrhage from an ulcer (author's transl)].
We present the case of a multiparous woman of 32 years of age who, at term after a more or less normal pregnancy, went into severe shock in labour. The patient in this case was very difficult to diagnose. Her life was only saved after massive blood transfusions and after delivering a fresh stillborn infant. It was not a case of uterine rupture nor of retro-placental haemorrhage. The site of origin of the hypovolaemic shock was intestinal. The patient had an ulcer of the pylorus which was diagnosed after fibroscopy. Some authors state that it appears that the few ulcers that have been diagnosed before pregnancy go into remission during pregnancy. All the same it would appear that sometimes very serious complicated ulcers which have to be treated with great respect do occur, especially in toxaemic patients at the end of pregnancy, and these carry with them a significant mortality both for the mother and the fetus. Although medical treatment (resuscitation) is essential, surgery should be resorted to if necessary because it may save the mother and sometimes the infant and so improve the prognosis of complicated ulcers occurring in pregnancy.
D000328:Adult; D001803:Blood Transfusion; D005260:Female; D005313:Fetal Death; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007744:Obstetric Labor Complications / Q000209:etiology*; D010298:Parity; D010438:Peptic Ulcer Hemorrhage / Q000150:complications* / Q000209:etiology; D010439:Peptic Ulcer Perforation / Q000150:complications*; D011247:Pregnancy; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000628:therapy; D013276:Stomach Ulcer / Q000150:complications*
Ulcère gastro-duodénal et grossesse. Etat de choc en cours de travail, par hémorragie digestive d'origine ulcéreuse.