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MANAGEMENT OF ANESTHESIA IN AN IMPENDING ECLAMPSIA PARTURIENT

WITH MULTIFORM GLIOBASTOMES

UNDERGO AN EMERGENCY SECTIO CAESAREAN, A CASE REPORT

Khairunnisai*, Buyung H.**, Isngadi**

Departemen Anestesiologi dan Terapi IntensifFakultas Kedokteran Uniersitas Bra!i"aya # $% dr %aiful An!ar &alang, 'a!a Timur

Abstract

Backgr!"#

The in(iden(e of )rain tumour in pregnant !omen is not kno!n, nono)stetri(

surgery during pregnan(y is +.-/, and in(iden(e of intra(ranial neoplasm in -01

years aged parturients is reported as 2.345++,+++. Intra(ranial neoplasms are rare

during pregnan(y, meningioma is the most (ommon !hereas glioma is een rarer .

%urgery for a deliery in a impending e(lampsia parturient !ith an intra(ranial tumor

!ithout a definitie surgery for the intra(ranial lession is een rarer and (an )e 6uite

(hallenging and diffi(ult for the anesthetist as it re6uires a fine )alan(e of )oth maternal

and fetal safety, and neuroprote(tion )rain, too.

P!r$s%

Des(ri)e ho! the management of anesthesia in impending e(lampsia parturient

!ith glio)lastom multiform that undergo emergen(y se(tio (aesarean .

Cas% R%$rt

An ery rare (ase, female 1+ years old hae 0+0 !eeks amenorhea !ith

emergen(y o)stetri(al (ondition i.e seere pree(lampsia and symptoms of impending

e(lampsia. In(reased intra(ranial pressure symptoms su(h nausea, omiting, and

)lurred of ision ar founded. A hystory of glio)astome 78B&9 multiformed and e(lampsiasei:ure at the 0rdpregnan(y sin(e one years ago !ith a poor o)edient phenytoin drug

therapy. A ;T s(an imaging !as performed and sho!ed a glio)lastomes 78B&9 multiform

at parietal lo)e deroteinuri 6ualitatie ?0 !as dete(ted from urinaly:ed. =ifedipin

and &agnesium sulphate 7&g%@19 !as giing in emergen(y room.

>i(ture 5. A head ;T s(an imaging sho!ed the glio)lastome multiform at de


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$outine preoperatie preparation !as performed !ith (orti(osteroid to redu(e

(ere)ral edem. >remedi(ation aspiration prophyla


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anesthesiologist in order to ensure that all (onsultants appre(iate the inherent risks and

to permit the anesthesiologist to plan the anestheti( appropriately. Both general

anesthesia and regional analgesia4anesthesia hae )een des(ri)ed !ith aria)le

out(omes. In order to ensure oerall maternal and fetal safety, the anestheti( te(hni6ue

(hosen should aoid flu(tuations in intra(ranial pressure 7I;>9, maintain a )rainneuroprote(tion , maintain a sta)le hemodynami(s and proide a suffi(ient depth of

anesthesia and analgesia. Ee report the su((esful use of general anesthesi, (om)ined

!ith multimodal )alan(ed analgesia for the management of a impending e(lampsia

patient !ith a glio)lastome tumour.

Key !ords management anesthesia, impending e(lampsia, se(tio (aesarean,

glio)lastome

R%)%r%"c%s

5. Khurana T.,Tane"a B.,%aediatri( Anesthesia Goal oriented

general anesthesia for caesarean section in parturient with a large intracranial

epidermoid cyst, 'uly 3 ++50. Isla A. et al, Brain tumor and pregnan(y. @)stet 8yne(ol 5333530.1. >eter ang E, 'ames &>., $eie! arti(les Neuroanesthesia for the pregnant

woman , Department of Anaesthesia and >ain &edi(ine, $oyal >erth Hospital,

and >harma(ology and Anaesthesiology Unit, %(hool of &edi(ine and

>harma(ology, Uniersity of Eestern Australia, >erth, Eashington, International

Anesthesia $esear(h, "anuary ++

-. Cl sayed AA et al, ;lini(al pra(ti(e arti(le A case series discussing theanaesthetic management of pregnant patients with brain tumours,

F5+++$esear(h +50, 3 ast updated + @;T +512. Cl sayed AA., and Ffarag C., ;ase study in =euroanesthesia and =euro(riti(al

;are Anesthetic management of pregnant patients with brain tumors, (hapter 22

pg 53, ;am)ridge uniersity press +55. Anonim, Anesthesia for (aesarean deliery , (hapter 5. 8oma Hala &., Management of Brain Tumor in Pregnancy-An Anesthesia

indow, (hapter 1, aaila)le athttp44d

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