Eisenmenger Syndrome pada wanita 23 Th dengan G1P0A0 Hamil 34 minggu dengan ASD Fungsional NYHA II yang menjalani Seksio Sesarea

ABSTRAK

SIndrom Eisenmenger merupakan suatu kondisi medis dimana terjadi aliran darah abnormal dalam jantung dimana terjadi shunt darikanan ke kiri yang biasanya disebabkan penyakit katup jantung yang dapat menyebabkan terjadinya hipertensi pulmonal. Sindrom Eisenmenger merupakan komplikasi yang serius dalam kehamilan. Tingkat kematian ±30-60% dapat disebabkan oleh hipersianotic spells, tromboemboli, hipovolume, hemoptisis, atau preeklamsia.

Dilaporkan  wanita 23 Th dengan G1P0A0 Hamil 34 minggu dengan ASD Fungsional NYHA II + Sindrom Eisenmenger, JTH (Janin Tunggal Hidup), Preskep (Presentasi Kepala). Pada kunjungan pre-operatif didapatkan pasien hamil cukup bulan dengan riwayat sesak nafas saat beraktivitas ringan. Dari hasil pemeriksaan ekokardiografi, kesan ASD secundum, sindrom Eisenmenger, hipertensi pulmonum.

Pasien menjalani operasi Seksio Sesarea dalam anestesi umum dengan intubasi nafas kendali. Untuk monitoring intraoperatif dilakukan pemasangan artery line dan central venous catheter.

Di meja operasi, dilakukan pemasangan monitor standar, dengan hemodinamik awal tekanan darah 122/79 mmHg, denyut jantung 102X/menit, laju nafas 23X/menit, SpO2 98%. Kemudian dilakukan pemasangan artery line pada arteri radialis dextra. Kemudian pasien diinduksi dengan midazolam 5 mg, fentanyl 300 meg, vecuronium 6 mg. Selanjutnya dilakukan pemasangan central venous catheter pada vena subelavia dextra

Kemudian lahir neonatus hidup, perempuan, BBL 2400 gram, PB 42 cm, APGAR Score 8/9. Selama operasi kondisi ibu stabil.

Paska operasi pasien dipindahkan ke ICU. Pasien dirawat selama 6 hari di ICU dan pindah ke ruang rawat inap dalam kondisi stabil.

 

Komentar:

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