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KMID : 0380319900460000127
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Journal of Korean Research Institute for Better Living
1990 Volume.46 No. 0 p.127 ~ p.138
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General Anesthesia in Pregant Patients with Preeclampsia
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Abstract
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Preeclampsia is a significant maternal disease manifested by functional derangement of multiple organs. The incidence of preeclampsia varies from region to region, occurring in approximately 0.2∼3.2％ of all pregnancies.
Although the etiology of preeclampsia is unknown, the possible underlying mechanism may be an imbalance in the production of prostacyclin and thromboxane. Also, te possibility of an immunologic disorder between the mother and the placenta has been debated.
The author report the laboratory observations, antihypertensive therapy and anesthetic management from 140 cases of mild and severe preeclampsia, and 70 cases of normal pregnancy.
The purpose of the present report is 1) to outline a labolatory profile of preeclampsia patient, and to offer a laboratory comparison with normal pregnant women 2) to determine if the labolatory findings and the therapy for preeclampsia have any clinical anesthetic significance.
There were significant differences in average body weight of mother and duration of pregnancy in each group.
In patients with preeclampsia, total protein, albumin, calcium values were decreased, but BUN, creatinine, uric acid values were increased significantly.
The platelet counts were significantly decreased in group 3, and FDP values were greater than 10ug/ml in 24 cases of group 3.
The abnormal findings on chest PA occurred in 12 cases of group 3, involving pulmonary edema in 4 cases.
The abnormal findings on EKG occurred in 26 cases of group 3, involving myocardial ischemia in 10 cases and sinus tachycardia in 7 cases.
The perioperative hypertension was treated with hydralazine and phenobarbital in 58.6％ of group 2, with hydralazine, phenobarbital and magnesium sulfate in 38.6％ of group 3.
Systolic and diastolic blood pressure in group 2 and 3 were significantly increased compared to group 1.
For the relaxation of muscle during anesthesia, vecuronium bromide was used in 85.7％ of group 1 and 61.4％ of group 2, but SCC dripping was used in 64.3％ of group 3.
The average body weight of neonate was decreased in group 3, of the 70 neonates, 25 cases were lower than 2.5㎏.
The Apgar score in 1 min and 5 min were significantly decreased in group 3.
The most common postoperative complication was anemin in all group, and pulmonary edema occurred in one case of group 3.
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