Manajemen Anestesi pada Pasien Atrial Septal Defect dan Hipertensi Pulmonal yang Menjalani Prosedur Seksio Sesarea

  • Haffidz Wahyu Aji Universitas Brawijaya
  • Isngadi Isngadi
Keywords: anestesi, atrial septal defect, hipertensi pulmonal, seksio sesarea

Abstract

Penyakit jantung merupakan penyebab yang berperan penting dalam morbiditas dan mortalitas selama masa kehamilan, proses persalinan, dan pasca persalinan. Salah satunya adalah atrial septal defect yang dapat menyebabkan beberapa komplikasi yang lebih serius seperti hipertensi pulmonal. Penyakit jantung dalam kehamilan yang tidak terkontrol dapat meningkatkan risiko terjadinya perburukan kondisi pada maternal. Perempuan, 38 tahun, G4P3003Ab000 hamil 37-38 minggu dengan atrial septal defect sekundum besar L to R shunt 63%, hipertensi pulmonal, bekas seksio sesarea, dan risiko tinggi dari segi usia lebih dari 35 tahun. Pada pemeriksaan fisik terdapat tekanan darah sebesar 103/48 mmHg, SpO2 97% dengan room air, dan murmur. Pada pemeriksaan ekokardiografi didapatkan atrial septal defect secundum besar Left-Right Shunt (63%), Hipertensi pulmonal,regurgitasi mitral ringan, regurgitasi pulmonal ringan, regurgitasi trikuspid ringan dengan kemungkinan hipertensi pulmonal tinggi. Pasien mendapatkan terapi berupa revatiol, ranitidin, metokloperamid, dan paracetamol. Pasien dilakukan prosedur seksio sesarea dengan teknik anestesi combine spinal epidural dengan menggunakan bupivakain 0,5% 7,5 mg dan fentanyl 25 mcg. Pasien tidak mengalami komplikasi perioperatif. Managemen anestesi yang tepat dalam kehamilan dengan atrial septal defect dan hipertensi pulmonal untuk mencegah terjadinya sindrom Eisenmenger yang dapat meningkatkan risiko perburukan kondisi pada pasien

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CROSSMARK
Published
2024-03-21
DIMENSIONS
Section
Case Report

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