Managemen Anestesi untuk Seksio Sesarea dengan Strok Maternal Hemoragik

Stroke is the third leading cause of morbidity and mortality in many developed countries. Cerebrovascular disease during pregnancy can result from three main mechanisms—bleeding, arterial infarction, venous thrombosis. Maternal stroke be either ischemic or hemorrhagic. Ischemic a common caused by loss blood supply to an area brain. Hemorrhagic bleeding into brain due rupture vessel. Cesarean section neurosurgical intervention should prioritized performed simultaneously important issue, as decision use general anesthesia spinal epidural when cesarean performed. The technique used made taking account overall maternal risk. Hyperventilation reduce intracranial pressure (ICP) kept range 25-30 mmHg because normal PaCO2 decreases 30-32 increased ventilation progesterone. mannitol control ICP, there are associated risks fetal dehydration; While other reports show that 0.2 0.5mg/kg has no significant effect on fluid balance. Special consideration needed for women with preeclampsia. General risk compared neuraxial preeclampsic women. Regardless preeclampic status, maintenance adequate oxygenation hemodynamic stability safety.