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Anesthesia Management on 29 Weeks Pregnant Women with Intracranial SOL, Invasive Carcinoma Mammae and Bronchopneumoniaes

1Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University/RSUP Dr. Kariadi, Semarang, Indonesia

2Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Received: 21 Feb 2023; Revised: 28 Mar 2023; Accepted: 11 Jul 2023; Published: 31 Mar 2024.

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Abstract

Background: Pregnancy gives whole different challenge for anesthesiologist because of we handle two lives at once. Brain tumor in pregnancy correlated with maternal mortality, prematurity and intra uterine growth restriction (IUGR). It makes delivery time, what kind of anesthesia technique we used choosen by the situation.

Case: We report a case of anesthesia technique using general anesthesia (GA) to accommodate sectio cesarean transperitoneal profunda (SCTP) in a 29 weeks pregnancy age, G1P0A0 female patient, ASA IIIE with intracranial SOL suspect cerebri abscess multiple dd/ tuberculoma, invasive mammae carcinoma, and bronchopneumoniae.

Disscussion: Space occupied lesion (SOL) is a lesion in intracranial space especially give effect to brain. In our patient with SOL from cerebri abscess multiple dd/ tuberculoma. It caused intracranial pressure increase and also spastic hemiparese dextra. Pregnancy termination was done depends on 29 weeks pregnancy with SOL in this patient. We used GA for cesarean section (CS). Anesthesia technique will be considered successful if new born baby activity, pulse, grimace, appearance, and respiration (APGAR) is good.

Conclusion: Female G1P0A0, 32 years old, 29 weeks pregnancy age, single intrauterine fetus with intracranial SOL suspect cerebri abscess multiple dd/ tuberculoma, invasive mammae carcinoma, and bronchopneumoniae was consulted by Obstetrician to Anestesiologist to do CS with GA. During anesthesia and surgery, there was no complication. In this case, termination was done for baby and mother’s well being.

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Keywords: cesarean section; general anesthesia; intracranial SOL; pregnancy; SCTP

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  1. Butt ME, Khan SA, Chaudrhy NA, Qureshi GR. Intracranial space occupying lesions: a morphological analysis. Biomedica. 2005;21(Jan- Jun)
  2. Kaki RR, Anuradha B, Rani BS, Rao KS, Kusumalatha P, Satyasuneetha K. IMAGING OF INTRACRANIAL SPACE OCCUPYING LESIONS- A PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE- GGH, KAKINADA, A.P. J Evid Based Med Healthc. 2017;4(11). doi: 10.18410/jebmh/2017/120
  3. Satyanegara. Ilmu Bedah Saraf. Edisi V. Jakarta: Gramedia; 2014
  4. Sajjad A, Naroo G, Khan Z, et al. Space Occupying Lesions (SOL) of the Brain - Clinical Manifestation with Subtle Neurological Symptoms in Emergency Department. J Adv Med Med Res. 2018;26(3). doi: 10.9734/jammr/2018/38701
  5. Rughani AI. Brain Anatomy. https://emedicine.medscape.com/article/1898830-verview#a6. Published 2015. Accessed June 24, 2022
  6. Toh CH, Wei KC, Chang CN, et al. Differentiation of pyogenic brain abscesses from necrotic glioblastomas with use of susceptibility-weighted imaging. Am J Neuroradiol. 2012;33(8). doi: 10.3174/ajnr.A2986
  7. Toh CH, Wei KC, Ng SH, Wan YL, Lin CP, Castillo M. Differentiation of brain abscesses from necrotic glioblastomas and cystic metastatic brain tumors with diffusion tensor imaging. Am J Neuroradiol. 2011;32(9). doi: 10.3174/ajnr.A2581
  8. Moon S-J, Ginat DT, Tubbs RS, Moisi MD. Tumor of The Brain. Cent Nerv Syst Cancer Rehabil. 2019:27-34
  9. Bokhari MR, Mesfin. FB. Brain Abscess. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022
  10. Burnstein R, Banerjee A. Anesthesia for Supratentorial Surgery. Essentials Neuroanesthesia Neurointensive Care. 2008:106-110. doi: 10.1016/B978-141604653-0.10016-0
  11. Rao GSU. Anaesthetic Management of Supratentorial Intracranial Tumours Brain. 2005;2(October):1- 9
  12. Gruenbaum SE, Meng L, Bilotta F. Recent trends in the anesthetic management of craniotomy for supratentorial tumor resection. Curr Opin Anaesthesiol. 2016;29(5):552- 557. doi: 10.1097/ACO.0000000000000365
  13. Leffert, L.R., Schwamm, L.H., 2013. Neuraxial anesthesia in parturients with intracranial pathology: A comprehensive review and reassessment of risk. Anesthesiology. doi: 10.1097/ALN.0b013e31829374c2
  14. Kumala Fajar Apsari, R., Suryono, B., Shinta, S., 2020. Manajemen anestesi pada pasien Seksio Sesarea Primigravida dengan Glioblastoma Multiforme. Jurnal Anestesi Obstetri Indonesia 2, 35–43. doi: 10.47507/obstetri.v2i1.3
  15. Bleeser T, Van Der Veeken L, Fieuws S, et al. Effects of general anaesthesia during pregnancy on neurocognitive development of the fetus: a systematic review and meta-analysis. Br J Anaesth. 2021;126(6):1128-1140
  16. Marulasiddappa V, Raghavendra B, Nethra H. Anaesthetic management of a pregnant patient with intracranial space occupying lesion for craniotomy. Indian J Anaesth. 2014;58(6):739-741
  17. Ramachandran A, Segaran S, Nikithamani, Ranjan R V. Neuraxial anaesthesia in a parturient with space occupying lesion in brain for caesarean section: Demystifying the myth – A case report with review. J Obstet Anaesth Crit Care 2022;12:164-6
  18. Durrani S, Akbar S, Heena H. Breast Cancer During Pregnancy. Cureus. 2018;10(7):e2941
  19. Hayashi, T.; Katayama, M.; Miyasaka, K.. General anesthesia for breast cancer surgery during pregnancy: a retrospective review at a breast cancer center in Tokyo between 1999 - 2011: 11AP5-2. European Journal of Anaesthesiology 30():p 178-178, June 2013
  20. Brito V, Niederman MS. Pneumonia complicating pregnancy. Clin Chest Med. 2011;32(1):121-132

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