Suspected of encountering an "obstetric killer"! Why is this disease so dangerous?, 32 year old American Olympic champion dies at home, Olympic gold medal | eclampsia | obstetrics

Last month, American female sprinter and Olympic gold medalist Tori Bowie died mysteriously at her home in Florida at the age of only 32, sparking widespread public attention. At that time, although the police had ruled out homicide, the cause of death had not yet been announced, and there were reports that Bowie was suspected to have been pregnant for 8 months when he passed away.

According to the Daily Mail on June 12th, a autopsy report has confirmed that Bowie died of complications during childbirth. She was 8 months pregnant at the time of her death and was "in labor.".

Tori Bowie profile map

According to reports, in early May this year, Bowie's family did not receive any news from her for several consecutive days and felt very worried, so they sought help from the police. On the afternoon of May 3rd local time, the police arrived at Bowie's residence and found her body on the bed.

At that time, the Daily Mail reported that Bowie was very thin when he passed away, but his body was already in a pregnant state, suspected to be 8 months pregnant. On June 12th, TMZ, an entertainment news website under AOL, reported that according to a obtained autopsy report, Bowie died from complications during childbirth. The autopsy report shows that she was 8 months pregnant at the time of her death and was "in labor" at the time.

It is understood that Bowie is an American track and field star, born in August 1990 in Mississippi, USA. She represented the US team and won three medals at the 2016 Rio Olympics, including a gold medal in the women's 4x100m relay, a silver medal in the women's 100m sprint, and a bronze medal in the 200m sprint. One year later, at the London World Championships, Bowie won the women's 100m sprint championship with a time of 10.85 seconds.

It is worth noting that Bowie's neighbors have stated that Bowie exhibited "strange and unsettling behavior" for a long period of time before his death. One of her neighbors said in an interview that he once saw Bowie standing on the street, holding a knife and shouting at a man.

According to the Urban Express, Bowie is suspected to have acute respiratory distress and eclampsia, and his whole body is in a convulsive state. Due to the absence of anyone else around, the fetus and mother died one after another.

The unfortunate passing of Bowie is regrettable, but at the same time, everyone is deeply shocked, "How terrifying is eclampsia?"

Dr. Li Yang, Director of Obstetrics and Gynecology at the First Affiliated Hospital of Zhejiang University School of Medicine, stated that preeclampsia is one of the critical and severe obstetric conditions, known as the "killer of obstetrics", which seriously endangers maternal and fetal health. Postpartum hemorrhage, hypertension, and infection are the three main causes of maternal mortality.

How fierce is preeclampsia?

What exactly is eclampsia, so aggressive? Director Li Yang stated that when it comes to preeclampsia, we must first talk about gestational hypertension, which includes gestational hypertension, preeclampsia, chronic hypertension with concurrent preeclampsia, and preeclampsia. Preeclampsia refers to the occurrence of elevated blood pressure and proteinuria after 20 weeks of pregnancy, as well as symptoms such as headache, blurred vision, nausea, vomiting, and upper abdominal discomfort. The incidence rate is about 4% of pregnant women, and it is the most severe stage of the development of gestational hypertension.

If combined with elevated liver enzymes, decreased platelets, headache, dizziness, nausea and vomiting, upper abdominal discomfort, or persistent pain in the right upper abdomen and other organ damage symptoms, it indicates that the condition is worsening and can be diagnosed as severe preeclampsia.

Without reasonable and effective treatment, the condition can progress to eclampsia and even accompanied by convulsions and coma, endangering the lives of pregnant women and fetuses.

"Patients with preeclampsia may experience concurrent cerebral hemorrhage and neurological damage caused by cerebral ischemia, which may persist and be the main cause of death," Director Li Yang said.

40 year old parturient's headache was not taken seriously all night

The next day, I was sent to the emergency department and suddenly had a seizure, which led to a seizure

"We receive several cases of severe preeclampsia pregnant women every month, mostly due to headaches, nausea, vomiting, and lower limb edema. The age is polarized, either younger or older. Eclampsia is a complication that should be avoided in perinatal health care," said Director Li Yang.

In 2022, the Obstetrics and Gynecology Department of the First Hospital of Zhejiang University admitted 76 pregnant women with severe preeclampsia, while the total number of cases in Zhejiang Province last year was 4242.

Director Li Yang was deeply impressed by a pregnant woman: "40 years old, a Hangzhou native, an elderly primipara, had diabetes during pregnancy, and had no choice in the local obstetric examination. At 28 weeks of gestation, she had a sudden headache one night, didn't care about it, and didn't go to the doctor. The next day, her mother knew the obstetrician, and after consulting, she suggested that she hurry to the emergency room. The family of the parturient was so worried that they sent her to the emergency room of our hospital, and began to twitch and coma in the emergency room." After receiving the emergency call, Director Li Yang's team rushed to the emergency room. The bedside ultrasound found that the fetal heart rate of the fetus had dropped to 80 times/minute, and immediately opened the green channel after giving the emergency tracheal intubation to the parturient. Operating room, emergency cesarean section, fortunately, mother and daughter are safe. The fetal score was good after cesarean section, and the patient was transferred to NICU for careful treatment, and was discharged after recovery.

Severe preeclampsia at 24 weeks of pregnancy

Unfortunate fetal death in the uterus

"If you feel unwell, you must seek medical attention in a timely manner and never delay," Director Li Yang reminded.

She once treated a young pregnant woman who suffered from chronic kidney disease, chronic hypertension, and obesity. At 24 weeks of pregnancy, the pregnant woman developed symptoms of preeclampsia such as convulsions. The local hospital recommended a referral. When she was sent to the emergency department of the Qingchun campus of Zhejiang University First Hospital at 120, the pregnant woman had convulsions and coma, and her condition had progressed to preeclampsia.

Director Li Yang and the on duty doctor rushed to the emergency department. The pregnant woman had developed hypoxemia and was given active treatment such as controlling convulsions, lowering blood pressure, relieving spasms, and sedation. At the same time, bedside ultrasound revealed that the fetus had lost its heart rate due to severe hypoxia and died in the uterus. After the control of preeclampsia and the stabilization of the condition, the obstetrics team induced labor for the parturient and delivered the fetus through a smooth delivery. Fortunately, the parturient was safe.

Preeclampsia can be prevented and controlled

These high-risk pregnant women should pay special attention to

"Only with hypertension can preeclampsia develop into preeclampsia. Preeclampsia can be detected and prevented early. In perinatal health care, it is necessary to avoid the occurrence of preeclampsia." Director Li Yang emphasized.

So, how to detect or prevent preeclampsia in a timely manner? Director Li Yang said that there are many high risk factors for pre eclampsia, such as primipara, twin or multiple pregnant women, obesity, history of pregnancy induced hypertension and family history, being too young or over 35 years old, chronic nephritis, proteinuria, pregnancy induced diabetes, pregnancy complicated with systemic lupus erythematosus, antiphospholipid syndrome and other immune system diseases. For pregnant women with these high risk factors, appropriate anticoagulant treatment and calcium supplementation should be carried out. During pregnancy, strict and regular prenatal examination should be carried out, and blood pressure, urine routine and other related indicators should be closely monitored.

When the following typical symptoms appear, it indicates that the condition has worsened and immediate medical attention is needed——

1. Persistent blood pressure ≥ 140/90mmHg;

2. Persistent and/or severe headaches;

3. Visual appearance of blind spots, photophobia, blurred vision, or temporary blindness;

4. Upper abdominal or stomach pain;

5. Nausea and vomiting;

6. Difficulty breathing and chest pain behind the sternum;

7. Both lower limb edema appears and progressively worsens.