UNCONSCIOUSNESS ECLAMPTIC PATIENT UNDERGOING EMERGENT

CAESARIAN SECTION: A CASE REPORT

Adityo Wibhisono, RTH Soepraptomo
Department of Anesthesiology and Intensive Care Medicine
Faculty of Medicine Sebelas Maret University – Dr. Moewardi Hospital Surakarta

Background
Patients with eclampsia are an emergency both for the obstetric and anesthesia, eclampsia occurs
due to damaged to endothelial cells in the human body. Patients are diagnosed with eclampsia if
they experience 1 or more seizures with or without decreased level of consciousness. Risk factors
that lead to eclampsia are repeated pregnancies, multiple pregnancies, and a history of
hypertension before pregnancy. As an anesthesiologist, we must be able to act quickly and
appropriately in handling emergency cases
Objective
This case report aimed to describe the management of unconsciousness eclamptic patient
undergoing emergent caesarian section
Case
Woman with G3P0A2 who were 32 weeks pregnant came to the emergency room with seizures
and decreased in consciousness. The patient had experienced twice seizures before being taken to
the hospital. The patient has a hypertension and eclampsia. Emergency caesarean section surgery
wass performed. Before the procedure the patient received MgSo4 4gr / IV followed by syringe
pump 2gr / hr to prevent seizure then intubated with the “Rapid Sequenced Induction technique”
using minimal inhalation agents to reduce the effect on uterine contractions.
Discussion
In the case of eclampsia with a decrease in consciousness, maintaining airway patency and
preventing occurence of seizure are compulsary. MgSo4 is the treatment choice for seizures in
pregnant women. Providing therapy in the event of severe hypertension, watching for signs of
increased intra-cranial pressure and limiting the amount of fluid entering as much as 80ml / hour
Conclusion
In managing ecllamtic pregnant women undergoing emergent caesarian section, controlling the
seizure, the hypertension and hypoxia are mandatory for anesthesiogist in order to provide good
outcome
Keywords: Eclampsia, Unconsciousness, Anesthesia
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