Anesthetic Management for Clipping of a Ruptured Cerebral Aneurysm before Vaginal Delivery in a Term Parturient: A case report. |
Hae Jin Lee, Yong Woo Choi |
Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. |
|
|
Abstract |
A ruptured cerebral aneurysm in a term parturient requires a consideration of several factors important to the survival of both the mother and infant. A 39-week pregnant patient with a subarachnoid hemorrhage, secondary to a ruptured anterior communicating artery aneurysm, presented emergently for clipping of a cerebral aneurysm under general anesthesia. Anesthetic goals for this patient included maintenance of maternal well-being, uteroplacental perfusion, and fetal well-being. Fetal monitoring consisted of fetal heart rate by external Doppler and uterine activity by external tocodynamometer. The aneurysm was well clipped, and the patient was in a good neurological grade after surgery. A healthy baby was delivered 7 days postoperatively via the vaginal route under epidural analgesia. The anesthetic management of the case is described and discussed. |
Key Words:
neurosurgical; delivery; labor; parturient; term; cerebral aneurysm; clipping |
|