Manajemen Anestesi Subarachnoid Block pada Pasien dengan Impending Eklampsia
Abstract
Pendahuluan: Impending eclampsia merupakan masalah yang serius dalam kehamilan karena komplikasi-komplikasi yang dapat timbul baik pada ibu maupun pada janin. Salah satu cara terbaik untuk meningkatkan keselamatan ibu dan bayi pada pasien dengan impending eklampsia adalah dengan dilakukan pembedahan caesar. Laporan Kasus: Pada kasus ini, akan dibahas lebih lanjut terkait wanita 39 tahun dengan G4P3A0 hamil 39 minggu dengan impending eclampsia. Pasien ini memiliki status fisik ASA III-E dan dilakukan tindakan sectio caesarea transperitoneal emergency dengan teknik anestesi regional subarachnoid block. Bayi lahir berjenis kelamin perempuan dengan APGAR score 7–8–9. Diskusi: Anestesi regional subarachnoid block dipilih karena mempunyai banyak keuntungan seperti kesederhanaan teknik, onset yang cepat, resiko keracunan sistemik yang kecil, blok anestesi yang baik, pencegahan perubahan fisiologi dan penanggulangannya sudah diketahui dengan baik. Kesimpulan: Diagnosis dan manajemen yang tepat pada ibu hamil dengan impending eclampsia sangat penting untuk kelangsungan hidup pasien. Pemilihan jenis anestesi subarachnoid block dipilih sesuai dengan kondisi klinis pasien dengan memperhitungkan segala aspek keuntungan, kerugian dan aspek medis lainnya.
Management Anesthesia Subarachnoid Block for Patient with Impending Eclampsia
Abstract
Introduction: Impending eclampsia is a serious problem in pregnancy because of complications that can arise both for the mother and the fetus. One way to speed up handling and improve the safety of mother and baby in patients with impending eclampsia is by caesarean section. Case Report: In this case, we will discuss about 39-year-old woman with G4P3A0 39 weeks pregnancy with impending eclampsia. This patient has ASA III-E physical status and performed transperitoneal emergency sectio caesarea under regional subarachnoid block anesthesia. The baby is female, born alive without abnormalities and has 7-8-9 APGAR score. Discussion: Regional subarachnoid block anesthesia was chosen because it has many advantages such as simple technic, rapid onset, a small risk of systemic poisoning, good anesthesia block, prevention of physiological changes, and its handling are well known. Conclusion: Proper diagnosis and management of pregnant women with impending eclampsia is very important for patient survival. The choice of subarachnoid block anesthesia is chosen according to the clinical condition of the patient by considering all aspects of the advantages, disadvantages, and other medical aspects.
Downloads
References
American College of Obstetricians and Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy.Obstet Gynecol. 2013;122(5):1122–31.
Angsar MD. ‘Hipertensi dalam kehamilan’, dalam Ilmu Kebidanan Sarwono Prawirodrdjo, edk 4, eds. T Rachimhadhi & Wiknjosastro GH, Bina Pustaka Sarwono Prawirohardjo: Jakarta. 2009.
Butterworth J, Mackey D, Wasnick J. Morgan & Mikhail's Clinical Anesthesiology, 5e. New York: McGraw-Hill Education. 2013
Cunningham, F. G., et al. (2010). Hipertensi dalam kehamilan dalam Obstetri Williams Edisi 21 Volume 2. Jakarta: Penerbit Buku Kedokteran EGC. 2010.
Dewi Y. Indikasi Sectio Caesaria. Tingkat Kecemasan suami menghadapi section cesarean pada istri di RSU Sembiring Medan. Skripsi: Medan. 2007
Dupont, J. Alima J, Kasia JM, Domgue JF. Maternal and Perinatal Complications of Severe Preeclampsia in Three Referral Hospitals in Yaoundé, Cameroon, (October), 2015, 723–730.
Faridz S, Wicaksono B, Dachlan EG, Widjiati. Penurunan progesterone-induced blocking factor sebagai penanda preeclampsia. Majalah Obstetri dan Ginekologi. 2016, 24: 13–18.
Goldenberg R. L, Jones B, Griffin JB, Rouse DJ, Trivedi N, Mcclure E M. Reducing maternal mortality from preeclampsia and eclampsia in low- resource Countries: What Should Work? R.L. Obstetric Anesthesia Digest. 2016 36(1).
Heazell A, Baker PN. Hypertensive disorders of pregnancy. Oakley C, Warnes CA, eds. Heart disease in pregnancy. 2nd ed. Massachusetts: Blackwell Publishing; 2007, 264–80.
Hikmah EV, Maryanto S, Ariesti ND. Hubungan kejadian preeklampsia dengan tindakan sectio caesarea di rumah sakit umum daerah Ambarawa Tahun 2014. Skripsi: STIKES Ngudi Waluyo Ungaran.
Kasdu D. Solusi Problem Persalinan. Jakarta: Puspa Swara. 2005
Lim KH. Preeclampsia. Beth Israel Deaconess Medical Centre: Israel. 2014
Mangku I, Senapati TGA. Ilmu Anestesia dan Reanimasi. Jakarta:Indeks. 2010
Mitayani. Asuhan keperawatan maternitas. Salemba medika: Jakarta. 2009
Prawirohardjo, Sarwono. Ilmu kebidanan. Jakarta: Yayasan Bina Pustaka. 2005
Primatika AD, Marwoto, Sutiyono D. Teknik Anestesi Spinal dan Epiural in Anestesiologi. IDSAI. 2010, 19: 325–30.
Ragasudha C, Madhav AP, Sharon S, Priya SS, Shehnaz S. A study of maternal deaths from preeclampsia and eclampsia in a tertiary care centre. IAIM 2018; 5 (1): 6–10.
Sa’adah N. Hubungan Antara Pertambahan Berat Badan Ibu Hamil Dengan Angka Kejadian Preeklampsia Di RSUD Dr. Moewardi Surakarta. Skripsi: Surakarta. 2013
Savaj S, Vaziri ND. An overview of recent advances in pathogenesis and diagnosis of preeclampsia. Iran J Kidney Dis. 2012; 6(5):334–8.
Shrestha AB, Sharma KR. Spinal anesthesia for cesarean section in preeclampsia. Postgraduated Medical Journal of NAMs. 2012; 12(2), 30–35.
Solomon CG, Seely EW. Brief review: Hypertension in pregnancy: A manifestation of the insulin resistance syndrome?.Hypertension. 2001; 37:232–9.
United Nations. United Nations Millennium Development Goals. http://www.un.org/millenniumgoals/maternal.shtml- Diakses Maret 2019. 2013
WHO. UNFPA, the World Bank, and the United Nations Population Division. Trends in maternal mortality: 1990 to 2013. World Health Organization, 201456; 2014
Jurnal Anestesi Obstetri Indonesia
