Favorable outcome of managing a pregnant woman with epidermolytic drug syndrome


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Background. Epidermolytic drug reactions (EDR) in pregnant women have been described in single cases. The mortality rates for Stevens-Johnson syndrome and Lyell syndrome are 5.0- 7.5% and 30-70%, respectively. The proven association of the syndromes with drugs, viral diseases necessitates systematization of practical knowledge, which is relevant for the management of pregnant women and the elaboration of obstetric tactics. Case report. The clinical case of a pregnant woman with EDR demonstrates diff iculties in the differential diagnosis of Stevens-Johnson syndrome with transformation into Lyell syndrome with hemorrhagic vasculitis, toxicoderma, psoriasis, and a favorable gestational outcome during medical treatment for a large lesion area. The management of pregnant near miss cases required an interdisciplinary approach. The capabilities of telemedicine are used to make consultations by specialists. Conclusion. The accumulation of clinical experience and the choice of medical policy with a high level of evidence will undoubtedly allow avoiding maternal and perinatal critical conditions in the medical management of pregnant women with EDR.

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作者简介

Yurii Tezikov

Samara State Medical University, Ministry of Health of Russia

Email: yra.75@inbox.ru
MD, professor, Head of the Department of Obstetrics and Gynecology No.l

Tatiana Tezikova

V.D. Seredavin Samara Regional Clinical Hospital

Email: t-tezikova@mail.ru
Deputy Chief Physician for Obstetrics and Gynecology, Perinatal Center

Igor Lipatov

Samara State Medical University, Ministry of Health of Russia

Email: i.lipatoff20i2@yandex.ru
MD, professor, professor of the Department of Obstetrics and Gynecology No. I

Roman Shmakov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: r_shmakov@oparina.ru
MD, professor of the RAS, director of the Institute of Obstetrics

Valentina Rakitina

V.D. Seredavin Samara Regional Clinical Hospital

Email: t-tezikova@mail.ru
Head of Obstetric Department, Perinatal Center

Elena Mishina

V.D. Seredavin Samara Regional Clinical Hospital

Email: t-tezikova@mail.ru
Head of Anesthesiology and Intensive Care Department, Perinatal Center

参考

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