Lalenoh, Diana Christine and Lalenoh, Hermanus J. and Bisri, Tatang
(2012)
ANESTHESIA MANAGEMENT IN SEVERE PRE-ECLAMPSIA
WITH IMPENDING ECLAMPSIA: A CASE REPORT.
2ND ANNUAL SYMPOSIUM ON ANESTHESIA COMPLICATIONS.
Abstract
Background
Preeclampsia is syndrome specific to pregnancy, diagnosed clinically by new onset of
hypertension and proteinuria after 20 weeks gestation. Pre-eclampsia complicates 2-7% of
pregnancies in developed countries and is a leading cause of maternal deaths. Associated
maternal mortality is 1.5 per 100 000 live births in the USA.
Objective
The objective of this case report is to understand anesthesia management in pre-eclamptic
-impending eclampsia, underwent cesarean section.
Case Report
We hereby present the anesthetic management of a patient with severe-preeclampsia
impending eclampsia. A female 26 year old, primigravida, 85kgs body weight, 155cm
of height, with 37-38 weeks gestation age, was admitted to our hospital with severe preeclampsia
impending eclampsia, because of severe headache, scheduled for caesarean
section. The induction were with propofol and fentanyl titration, muscle relaxant facilitation
was Rocuronium 50 mg, intubation with Endotracheal Tube no.7, maintenance with
Oxygen:N20 (3:3), and lsoflurane. Mter 2 hours, thesurgery procedure was ended. The
patient was transferred to leD.
Discussion
Pre-eclamptic patient generally require extra caution during anesthesia; they require
stabilization prior to any anesthetic. Hypertension should be controlled and hypovolemia
corrected before anesthesia. Anesthetic approach must consider the following issues:
perieoperative risk assessment, the specific pre-eclampsia manifestation and complication
being treated and basic knowledge of pathophysiology in pre-eclamptic, an awareness
of potential airway difficulties, anesthetic choices, intraoperative medical management
decision-making (hemodynamic goals, pulmonary fimction), and postoperative airway
concerns and pain management.
Conclusions I
Moreover, general anesthesia have a good outcome in severe-impending eclamptic patient
underwent cesarean section.
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