ANAESTHESIA MANAGEMENT PATIENT WITH ECLAMSIA AND

UNCONSCIOUSNESS: A CASE REPORT

dr. Adityo Wibhisono
dr. dr. RTH Soepraptomo Sp.An KAO
Department of Anesthesiology and Intensive Care Medicine
Faculty of Medicine Sebelas Maret University – Dr. Moewardi Hospital Surakarta – Central Java
– Indonesia

Background
Patients with eclampsia are an emergency both in the obstetric and anesthesia, eclampsia occurs
due to damage to endothelial cells in the human body. Patients are called eclampsia if they
experience 1x or more seizures with decreased consciousness or not. Risk factors that lead to
eclampsia of 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
Case
Women with G3P0A2 who were 32 weeks pregnant came to the emergency room with seizures
accompanied by a decrease in consciousness. The patient had 2x seizures before being taken to the
hospital. The patient has a history of hypertension before pregnancy, the obstetrician is diagnosed
with eclampsia and emergency cesarean section surgery will be performed. Patients were given
MgSo4 4gr / IV followed by syringe pump 2gr / hr. The patient is then taken to the operating room
and intubated with the "Rapid Sequenced Induction" technique and uses minimal inhalation agents
to reduce the effect on uterine contractions.
Discussion
In the case of eclampsia with a decrease in our consciousness as anesthesia is obliged to always
maintain the patency of the airway and try to prevent seizures from returning. Giving MgSo4
medication is the treatment of choice for dealing with 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
Defenitive therapy of eclampsia is pregnancy termination, however pregnancy termination is not
good when the mother and baby are unstable. When seizures are controlled, severe hypertension
has been resolved and symptoms of hypoxia have been treated it will be provide better outcome
Keywords: Eclampsia, unconsciousness, Anesthesia
REFERENCES
1. Morgan, G. E., Mikhail, M. S., dan Murray, M. J. 2006. Obstetric Anesthesia. In Morgan
GE, ed. Clinical Anesthesiology 4th edn. USA; McGraw-Hill Companies. P 858-2.
2. Chestnut,David.H., 2014, obstretric anesthesia and practice fifth edition, United States of
America, elsevier, p: 825-852.
3. Cunningham FG, Leveno KJ. 2010.Pregnancy hypertension 23rd ed chap 34. New
York:mcgraw-hill, p:706-56