A Case Report on Regional Anaesthesia in Pregnant Women with Severe Pre-Eclampsia, Partial Hellp Syndrome, Fetal Distress, and Type II Diabetes Mellitus

Abstract

ABSTRACT Background: Maternal mortality in Indonesia is caused by multifactors that are both direct and indirect factors. Complications during pregnancy and after delivery, including preeclampsia is the direct cause of 90% of maternal deaths. This case report aimed to describe the anaesthesia management on the incidence of severe preeclampsia to prevent the complications. Subjects and Method: We reported a 33-year-old G3P2A0 woman with 33 weeks of gestational age, diagnosed with severe pre-eclampsia partial HELLP syndrome, fetal dis-tress, type II diabetes mellitus pro SCTP emergency with physical status ASA II. Regional anaesthesia with sub-arachnoid block was performed by using Lidodex 75 mg and fentanyl 25 mcg intrathecally. Results: From the operation process, a baby boy with birth weight 2.900 gram and APGAR Score 7-8-9 was born. Two-hour post operation examination on patient showed compos mentis (consciousness), blood pressure 121/ 80 mmHg, heart rate 64 bpm, respiration rate 20 breath per minute, blood oxygen saturation levels (SpO2) 99% with 3 L/min nasal cannula. Patient was administered to HCU post operation to be monitored vital sign and signs of impending eclampsia. Post-operative refeeding was performed after bowel sound was positive. Conclusion: Selection of appropriate anaesthetic management in severe preeclampsia cases can prevent complications. Keywords: severe preeclampsia, sectio caesaria, regional anesthesia, subarachnoid block Correspondence: R. Th. Supraptomo. Department of Anaesthesiology and Intensive Therapy Dr. Moewardi Hospital. Jl Kolonel Sutarto 132 Jebres, Surakarta, Central Java, 57126. Email: ekasatrio-@gmail.com. Mobile: +6281329025599. DOI: https://doi.org/10.26911/the7thicph.05.29