Epidural Labour Analgesia pada Pasien Hamil dengan Sindrom Eisenmenger

*Juni Kurniawaty  -  Bagian Anestesiologi dan Terapi Intensif; Fakultas Kedokteran; Kesehatan Masyarakat dan Keperawatan; Universitas Gadjah Mada; Yogyakarta, Indonesia
Published: 1 Jul 2019.
DOI: https://doi.org/10.14710/jai.v11i1.22899 View
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Section: Tinjauan Pustaka
Language: ID
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Abstract

Sindrom Eisenmenger didefinisikan sebagai hubungan abnormal antara sirkulasi sistemik dan paru berupa pirau kiri ke kanan yang berbalik menjadi kanan ke kiri akibat tingginya resistensi vaskular paru. Wanita hamil dengan sindrom Eisenmenger disarankan untuk menghentikan kehamilan, tetapi jika pasien tetap memilih untuk melanjutkan kehamilan, maka sebaiknya masuk rumah sakit pada usia kehamilan 25 minggu, bed rest selama periode sisa kehamilan, diberikan oksigen selama periode sesak napas dan dilakukan pemeriksaan analisis gas darah serial untuk mendeteksi perubahan di dalam aliran shunt. Apabila pilihan mode persalinanannya adalah persalinan normal, maka pada onset dari persalinan, dilakukan insersi kateter epidural, dilakukan pemantauan dengan monitor hemodinamik invasif dan apabila terjadi penurunan tekanan darah seharusnya segera diterapi dengan pemberian vasopressor serta setiap kehilangan darah dilakukan transfusi. Pasien seharusnya tetap di dalam rumah sakit sampai 7-14 hari setelah persalinan.

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Keywords: epidural labour analgesia; hipertensi pulmonal; kehamilan; persalinan spontan; sindrom Eisenmenger

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