Korean J Anesthesiol.  2001 Sep;41(3):398-403. 10.4097/kjae.2001.41.3.398.

Anesthetic Management for Clipping of a Ruptured Cerebral Aneurysm before Vaginal Delivery in a Term Parturient: A case report

• Lee HJ
• Choi YW

• KMID: 2031895
• DOI: http://doi.org/10.4097/kjae.2001.41.3.398

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.

Keyword

neurosurgical; delivery; labor; parturient; term; cerebral aneurysm; clipping

MeSH Terms

Analgesia, Epidural
Anesthesia, General
Aneurysm
Female
Fetal Monitoring
Heart Rate, Fetal
Humans
Infant
Intracranial Aneurysm*
Mothers
Perfusion
Pregnancy
Subarachnoid Hemorrhage