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Abstract
Background
The incidence of brain tumour in pregnant women is not known, non-obstetric
surgery during pregnancy is 0.75-2%, and incidence of intracranial neoplasm in 25-34
years aged parturients is reported as 6.9/100,000. Intracranial neoplasms are rare
during pregnancy, meningioma is the most common whereas glioma is even rarer .
Surgery for a delivery in a impending eclampsia parturient with an intracranial tumor
without a definitive surgery for the intracranial lession is even rarer and can be quite
challenging and difficult for the anesthetist as it requires a fine balance of both maternal
and fetal safety, and neuroprotection brain, too.
Purpose
Describe how the management of anesthesia in impending eclampsia parturient
with glioblastom multiform that undergo emergency sectio caesarean .
Case Report
An very rare case, female 40 years old have 30-32 weeks amenorhea with
emergency obstetrical condition i.e severe pre-eclampsia and symptoms of impending
eclampsia. Increased intracranial pressure symptoms such nausea, vomiting, and
blurred of vision ar founded. A hystory of gliobastome (GBM) multiformed and eclampsia
seizure at the 3rd pregnancy since one years ago with a poor obedient phenytoin drug
therapy. A CT scan imaging was performed and showed a glioblastomes (GBM) multiform
at parietal lobe dextra with vasogenik oedem. Neurological deficits in form right
hemiestesia, right quadrinopsia, and gravidarum polyneuropathy. Hypertension is
untreat since second month of pregnancy with blood pressure range 150-170/90-100
mmHg without therapy. Proteinuri qualitative +3 was detected from urinalyzed. Nifedipin
and Magnesium sulphate (MgSO4) was giving in emergency room.
anesthesiologist in order to ensure that all consultants appreciate the inherent risks and
to permit the anesthesiologist to plan the anesthetic appropriately. Both general
anesthesia and regional analgesia/anesthesia have been described with variable
outcomes. In order to ensure overall maternal and fetal safety, the anesthetic technique
chosen should avoid fluctuations in intracranial pressure (ICP), maintain a brain
neuroprotection , maintain a stable hemodynamics and provide a sufficient depth of
anesthesia and analgesia. We report the succesful use of general anesthesi, combined
with multimodal balanced analgesia for the management of a impending eclampsia
patient with a glioblastome tumour.
Key words : management
glioblastome
References
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F1000Research 2013, 2:92 Last updated: 02 OCT 2014
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