Spinal Anesthesia in Caesarean Section with Ovarian Cyst Permagna with Meigs Syndrome

A. Iqbal, S. Sembiring
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Abstract

Background: The ovarian cyst is the very common cyst intra-abdominal in the ovary. If it need termination, the common procedure is cesarean section then the best anesthesia technique that suitable is spinal anesthesia. The Meigs Syndrome is an uncommon clinical condition, in which benign ovarian tumors are usually accompanied by ascites and pleural effusion. About 1% of ovarian tumors can indicate Meigs syndrome. Meigs Syndrome case have been reported in woman before 30 years old.Case Illustration: We reported an evaluation of a 29 years old woman, Gestational 1 Partus 3 Abortus 0, 60 kg weight and 165 cm height came to hospital with enlargement of abdomen since 3 months ago. There wasn’t history of bleeding and fluid discharged from genital. There’s no complaint in urination and defecation. The patient has felt an enlarged abdomen since the age of 7 months of pregnancy during antenatal care to a obstetrician. The patient hemodynamic and vital signs are stable and the pregnancy already in 37-38th week. Based on that the obstetrician decided to terminate the pregnancy, we choose to do spinal anesthesia in the cesarean section because it’s easy, common, and best technique for short surgical procedures.Conclusion: In patient with Ovarian Cysts Permagna with Meigs Syndrome in Pregnancy, we need to understand the risk of complication of ovarian cyst is higher in the prenatal period than after birth. The diagnosis of fetal ovarian cyst should not affect the schedule and method of delivery. The management of Meigs Syndrome in Pregnancy this time we terminate the pregnancy because it’s already in 37-38th week, the spinal anesthesia management is nothing different with the normal pregnancy.
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脊髓麻醉在子宫剖宫产伴Meigs综合征卵巢Permagna囊肿的应用
背景:卵巢囊肿是卵巢最常见的腹腔内囊肿。如果需要终止妊娠,常见的方法是剖宫产,那么最合适的麻醉技术是脊髓麻醉。Meigs综合征是一种罕见的临床疾病,其良性卵巢肿瘤通常伴有腹水和胸腔积液。约1%的卵巢肿瘤可提示梅格斯综合征。Meigs综合征病例多见于30岁以前的女性。病例说明:我们报告了一名29岁的女性,体重60公斤,身高165厘米,3个月前因腹部肿大而入院。没有生殖器出血和液体排出史排尿和排便均无不适。自怀孕7个月以来,患者在产科医生的产前护理中感到腹部肿大。患者血流动力学及生命体征稳定,妊娠已在37 ~ 38周。在产科医生决定终止妊娠的基础上,我们选择在剖宫产手术中进行脊髓麻醉,因为这是一种简单、常见、最短手术过程中最好的技术。结论:妊娠期Permagna卵巢囊肿合并Meigs综合征的患者,需要认识到产前发生卵巢囊肿并发症的风险高于出生后。胎儿卵巢囊肿的诊断不应影响分娩的计划和方法。妊娠Meigs综合征的处理这次我们终止妊娠因为已经是37-38周了,脊髓麻醉处理与正常妊娠没有什么不同。
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