KMID : 1155520200150030319
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Anesthesia and Pain Medicine 2020 Volume.15 No. 3 p.319 ~ p.324
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Spinal anesthesia for urgent Cesarean section in a patient with uncontrolled hyperthyroidism due to Graves¡¯ disease - A case report -
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Park Sang-Yoong
Choi So-Ron Jeong Joon-Ho Kim Jeong-Ho
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Abstract
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Background: Effective treatment of Graves¡¯ disease during pregnancy is important because uncontrolled hyperthyroidism is associated with increased fetal and maternal morbidity and mortality. While there have been case reports of patients with Graves¡¯ disease who failed to achieve euthyroid state during pregnancy, anesthesiologists rarely encounter patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.
Case: A 31-year-old pregnant patient had uncontrolled hyperthyroidism due to Graves¡¯ disease despite medical treatment. Her signs and symptoms suggested fetal distress and aggravation of the disease, leading to hospitalization. After a failed induction for vaginal delivery, an urgent Cesarean section was performed under spinal anesthesia via an interlaminar approach using 9 mg of 0.5% heavy bupivacaine and 20 ¥ìg of fentanyl. It resulted in successful delivery, with no perioperative complications for the mother and neonate.
Conclusions: This case demonstrates that spinal anesthesia may provide clinical stability to patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.
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KEYWORD
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Cesarean section, Emergencies, Hyperthyroidism, Spinal anesthesia
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