Anestesia para gestante com síndrome HELLP: relato de caso

Zuccolotto, Eduardo Barbin; Neto, Eugenio Pagnussatt; Nogueira, Glínia Cavalcante; Nociti, José Roberto

doi:10.1016/j.bjan.2014.05.013

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…. This presentation of the severe PE originates from an abnormal placental development, which progresses with the production of factors that lead to endothelial injury through the activation of platelets and/or vasoconstrictor agents 4 . This patient, differently from the usual, was 19 years old.…”

Section: Discussionmentioning

confidence: 99%

“…The severe PE is defined by SAP ≥ 160 mmHg and/or DAP ≥ 110 mmHg, and it can be followed by proteinuria ≥ 5 g/day, oliguria (< 500 mL/day), elevated serum creatinine, fetal growth restriction, pulmonary edema, neurologic manifestations (headache, visual disturbances, seizure or stroke), hepatic manifestations or HELLP syndrome (Hemolysis Elevated Liver enzymes Low Platelets), condition described by Louis Weinstein in 1982 3 . The HELLP syndrome consists of an advanced staged of PE 3,4 and it can affect 0,6% of gestations and 4-12% of patients with severe PE, developing high maternal (24%) and perinatal (up to 40%) mortality rates 5,6 . It presents clinically with unspecific symptoms, such as general malaise, epigastralgia, right hypochondrium pain, nausea and vomits, headache and scotomas.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

Rodrigues¹,

Dias²,

Oliveira³

et al. 2017

Rev Pat Tocantins

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The HELLP syndrome – defined as haemolysis, elevated liver enzymes and thrombocytopenia – consists of an advanced stage of preeclampsia (PE), which can affect 0.6% of pregnancies and 4-12% of patients with severe PE. Being responsible for elevated maternal and perinatal mortality rates, it can present with general malaise, epigastralgia, right hypochondrium pain, nausea and vomits, headache, scotomas, associated with hypertension and proteinuria. Woman, 19 years old, primigest, admitted with 29 weeks of gestational age presenting with arterial hypertension (160/120 mmHg), headache, scotomas, nausea and vomits. She showed regular health status, pallid, closed, anterior and soft cervix, with no fluid losses, and inaudible fetal heart rate on the sonar. She was stabilized with intravenous hydration and antihypertensive drugs, the ultrasonography showed placental abruption and fetal death. An uneventfully caesarean operation was performed under general anaesthesia. Due to the low haemoglobin, haematocrit and platelet levels, she received blood transfusion, progressing with clinical and laboratory improvement. The pressure control was met by the use of methyldopa, nifedipine and pindolol, and she was discharged with a good health status at the 10th day of hospitalization, with scheduled return for reassessment. Keywords: HELLP syndrome, severe preeclampsia, fetal death, placental abruption. A síndrome HELLP – definida por hemólise, enzimas hepáticas elevadas e plaquetopenia – consiste em estágio avançado de pré-eclâmpsia (PE), podendo afetar 0,6% das gestações e 4-12% das pacientes com PE grave. Responsável por elevados índices de mortalidade materna e perinatal, pode se apresentar com mal estar geral, epigastralgia, dor em hipocôndrio direito, náuseas ou vômitos, cefaleia, escotomas, assoaciado a quadro hipertensivo e proteinúria. Mulher de 19 anos, primigesta, admitida com 29 semanas de idade gestacional com quadro de hipertensão arterial (160/120 mmHg), cefaleia, escotomas, náuseas e vômitos. Apresentava regular estado geral, hipocorada, colo uterino fechado, anterior, amolecido e sem perdas e batimento cardiofetal inaudível ao sonar. Estabilizada com hidratação venosa e anti-hipertensivos, foi realizada ultrassonografia que evidenciou descolamento prematuro de placenta e óbito fetal. Realizada cesariana sob anestesia geral sem intercorrências. Devido a baixos níveis de hemoglobina, hematócrito e plaquetas, foi hemotransfundida, apresentando melhora clínica e laboratorial. O controle pressórico foi atingido com uso de metildopa, nifedipina e pindolol, recebendo alta em bom estado geral no 10º dia de internação hospitalar com programação de retorno para reavaliação. Palavras-chave: Síndrome HELLP, Pré-eclâmpsia grave, óbito fetal, descolamento placentário.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

Rodrigues¹,

Dias²,

Oliveira³

et al. 2017

Rev Pat Tocantins

View full text Add to dashboard Cite

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“…It is characterized by hemolysis, thrombocytopenia and elevation of liver enzymes and can affect approximately 4-12% of cases of severe preeclampsia, with a high maternal and perinatal mortality of 24% and 40% respectively. 6 In this context, hypertensive syndromes are among the main causes of maternal death, and the reduction of maternal mortality by 75%, by the year 2015, was one of the objectives established in the Millennium Development Goals, which has not materialized in several countries, among them, Brazil. 4 Pre-eclampsia is considered a major cause of maternal and perinatal morbidity and mortality, complicating about 5-7% of pregnancies worldwide, with an increased risk of eclampsia, pulmonary edema, stroke, renal and hepatic dysfunction, and death, in the absence of interventions.…”

mentioning

confidence: 99%

“…7,8 In Brazil, it reaches incidence levels of 7.5%. 6 In addition, the highest number of cases of maternal near miss, occur in hypertensive syndromes, as documented in a study conducted in an intensive care unit (ICU) of Recife-PE hospital, which presented a rate of 62.7%, 42.3% of severe preeclampsia, 13.7% of eclampsia, 6.7% of chronic hypertension aggravated during pregnancy and 41.2% of HELLP syndrome. 9 In addition to maternal complications, adverse events to the fetus, such as prematurity, fetal anomalies, decreased intrauterine growth, intrauterine fetal death and small gestational age (SGA) are described as being associated with pre-eclamptic conditions.…”

mentioning

confidence: 99%

Mulheres com síndromes hipertensivas

Mariano¹,

Belarmino

Vasconcelos³

et al. 2018

Rev enferm UFPE on line.

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RESUMOObjetivo: descrever o perfil obstétrico de mulheres com síndrome hipertensiva. Método: estudo quantitativo, exploratório, descritivo, retrospectivo e de delineamento documental, com 196 prontuários de pacientes com síndromes hipertensivas, no período de novembro de 2016 a maio de 2017. Para a coleta dos dados, foi utilizado um formulário. Em seguida, eles foram agrupados e organizados em uma planilha Excel e, posteriormente, convertidos em tabela. Resultados: a faixa etária predominante das pacientes estava entre os 16 aos 30 anos, com 68,88%; em relação ao número de partos, 55,61% eram multíparas; sobre o acompanhamento do pré-natal, 87,76% das gestantes tiveram acima de seis consultas; 89,80% das gestações eram únicas e 10,20%, gemelares; 57,27% dos recém-nascidos eram do sexo masculino e 42,73% eram do sexo feminino, apresentando 0,45% dos recém-nascidos com APGAR menor que sete no quinto minuto de vida e 99,55% com APGAR maior que sete. Conclusão: o estudo mostrou-se necessário para identificar fatores de risco que auxiliam na qualificação da assistência à mulher. Descritores: Gestação; Perfil de saúde; Pré-eclâmpsia; Eclâmpsia; Síndrome HELLP; Enfermagem.ABSTRACT Objective: to describe the obstetric profile of women with hypertensive syndrome. Method: a quantitative, exploratory, descriptive, retrospective and documental study, with 196 charts of patients with hypertensive syndromes, from November 2016 to May 2017. A form was used, to collect the data. Then they were grouped and organized into an Excel spreadsheet and then converted to a table. Results: the predominant age group was between 16 and 30 years old, with 68.88%; in relation to the number of births, 55.61% were multiparous; about prenatal follow-up, 87.76% of pregnant women had more than six consultations; 89.80% of pregnancies were single and 10.20% of twins; 57.27% of the newborns were male and 42.73% were female, presenting 0.45% of newborns with APGAR lower than seven in the fifth minute of life and 99.55% with APGAR greater than seven. Conclusion: the study was necessary to identify risk factors that help in the qualification of women's care. Descriptors: Pregnancy; Health Profile; Preeclampsia; Eclampsia; HELLP Syndrome; Nursing. RESUMEN Objetivo: describir el perfil obstétrico de mujeres con síndrome hipertensivo. Método: estudio cuantitativo, exploratorio, descriptivo, retrospectivo y de delineamiento documental, con 196 prontuarios de pacientes con síndromes hipertensivos, en el período de noviembre de 2016 a mayo de 2017. Para la recolección de datos, se utilizó un formulario. A continuación, ellos fueron agrupados y organizados en una hoja de cálculo de Excel y, posteriormente, convertidos en la tabla. Resultados: el grupo de edad predominante de las pacientes estaba entre los 16 a los 30 años, con el 68,88%; en relación al número de partos, el 55,61% eran multíparas; sobre el seguimiento del prenatal, el 87,76% de las gestantes tuvieron más de seis consultas; El 89,80% de las gestaciones eran únicas y el 10,20%, gemelares; El 57,27% de los recién nacidos eran del sexo masculino y el 42,73% eran del sexo femenino, presentando el 0,45% de los recién nacidos con APGAR menor que siete en el quinto minuto de vida y el 99,55% com APGAR mayor que siete. Conclusión: el estudio se mostró necesario para identificar factores de riesgo que auxilian en la calificación de la asistencia a la mujer. Descriptores: Embarazo; Perfil de Salud; Pre-Eclampsia; Eclampsia; Síndrome HELLP; Enfermera.

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ObsTIVA‐UK: a service evaluation of obstetric total intravenous anaesthesia in the United Kingdom

Metodiev,

Iliff,

Sharif

et al. 2024

Anaesthesia Reports

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SummaryWe conducted a prospective observational service evaluation across the United Kingdom on the use of total intravenous anaesthesia (TIVA) for obstetric surgery between November 2022 and June 2023. The primary aim was to describe the incidence of TIVA for obstetric surgery within participating units, with secondary aims to describe maternal and neonatal postoperative recovery indicators. Of 184 maternity units in the United Kingdom, 30 (16%) contributed data to the service evaluation. There were 104 patients who underwent caesarean delivery under TIVA and 19 patients had TIVA for other reasons. Infusions of propofol and remifentanil were used in 100% and 84% of cases, respectively. Fifty‐nine out of 103 live neonates (57%) required some form of respiratory support. Of the neonates with recorded data, 73% and 17% had Apgar scores < 7 at 1 and 5 min respectively. No neonates were recorded to have Apgar scores < 7 at 10 min. Further prospective research is required to investigate the impact of obstetric TIVA on maternal and neonatal outcomes and inform best practice recommendations.

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Anestesia para gestante com síndrome HELLP: relato de caso

Cited by 7 publications

References 9 publications

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

Mulheres com síndromes hipertensivas

ObsTIVA‐UK: a service evaluation of obstetric total intravenous anaesthesia in the United Kingdom

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