Hemoglobinuria in pregnancy
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Hemoglobinuria in pregnancy(haemoglobinur a gravidarum; from hemoglobin and Greek urine) - the appearance of free hemoglobin in the urine;is caused by intravascular hemolysis and subsequent release of hemoglobin by the kidneys.
Normal in healthy women with fiziol. In the course of pregnancy, the free plasma hemoglobin is 4 mg /% and is fully bound by haptoglobin without penetrating the renal filter. G. is a consequence of the decrease in hemoglobin-binding ability of haptoglobin. It occurs with congenital hypogaptoglobinemia and long-term intravascular hemolysis. Urine when standing acquires a dark color (black beer or a strong solution of manganese), which is caused by methemoglobin. G. occurs as a result of hemolysis during transfusion of incompatible blood, infusion of hypotonic. r-ditch, with the poisoning of hemolytic. poisons (hydrogen sulfide, acetic essence, snake and mushroom poisons, etc.), anaerobic sepsis, burns.
CLINIC: severe general condition (fever, headache, pain in muscles, joints), jaundice, anemia, hypoxia, collaptoid, coma, anuria, uremia.
TREATMENT: systematic transfusions of fresh whole blood, washed red blood cells, hemosorption, hemodialysis. Symptomatic therapy - osmodiuretiki (seeDiuretics), rheologically active solutions, soda, glucose, vitamin preparations, cardiac glycosides, oxygen.