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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Medicine and Health Technology
Khaidar, Reyfal
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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A Diagnostic Challenge in the Differential Diagnosis of Recurrent Seizures During Pregnancy: Epilepsy Versus Eclampsia Andri Subiantoro; Sugiharto, Wahyu; Khaidar, Reyfal
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 1 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I12025.35-44

Abstract

Introduction: Seizures during pregnancy are associated with adverse outcomes for mothers and infants. Seizures during pregnancy can be associated with multiple factors. To establish effective treatment and management of seizures, it is important to identify all of the factors that may contribute to seizures during pregnancy. Objective: This study aimed to evaluate and identify the cause of seizures in pregnancy to facilitate appropriate treatment. Case Report: We present a case of a 32-week pregnant woman who experienced eclampsia and recurrent seizures during the peripartum period. The patient had a history of inadequately managed epilepsy. Seizure management required multiple medications, including magnesium sulfate, benzodiazepine, and phenytoin. The patient underwent an emergency caesarean utilizing the Rapid Sequence Intubation (RSI) procedure and general anesthesia to rescue the baby. Nicardipine, furosemide, isosorbide dinitrate, captopril, spironolactone, and hydrochlorothiazide were used to manage blood pressure. The patient needs to be continuously observed, and the therapy should be adjusted according to the patient’s condition. Discussion: The patient had a history of epilepsy and had experienced two bouts of generalized seizures with characteristics of eclampsia before being arrived at the emergency room. Determining how to control the seizures in this spesific individual was a challenge. The primary therapy of patients with active seizures should include maintaining the airway, respiration, and circulation. The therapeutic objectives are immediate delivery of a viable fetus and maintenance of maternal health. Perioperative management aims to control blood pressure and seizures, maintain hemodynamics, manage anesthesia for terminating a pregnancy, and support critical care management for any potentially fatal complications from this condition. Conclusion: Seizures in pregnancy are attributable not just to eclampsia but can also cause by another or concurrently together with other causes. Early diagnosis and appropriate treatment are required to achieve the best outcome for this patient.
Epilepsy or Eclampsia in Differential Diagnosis of Recurrent Seizures in Pregnancy Aisyiyah Bojonegoro Hospital: A Diagnostic Dilemma? A Case Report Khaidar, Reyfal; Fitri, Wafa Sofia; Sania, Hen; Rahman, Mafida Wida; Modjo, Annisa Afiyatushsholihah; Subiantoro, Andri; Indriani, Ratri Dwi; Zammara, Abdurrahman; Ridho, Muhammad Ainur Rosyid
Journal of Medicine and Health Technology Vol. 1 No. 2 (2024)
Publisher : Direktorat Riset dan Pengabdian Kepada Masyarakat, Institut Teknologi Sepuluh Nopember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12962/j30466865.v1i2.1196

Abstract

Seizures in pregnancy can lead to adverse maternal and perinatal outcomes, often arising from various factors necessitating clear diagnosis for effective therapy. Concurrent occurrence of multiple causative factors can complicate diagnostic and therapeutic decisions. We present a case of a 32-week pregnant woman with poorly managed epilepsy who experienced eclampsia and recurrent seizures. Treatment involved multiple medications and emergency cesarean delivery with meticulous blood pressure control. Close monitoring and therapy adjustment were crucial. Managing seizures in such cases poses a dilemma, necessitating initial focus on airway, breathing, and circulation stabilization. Immediate delivery of a viable fetus and maternal health maintenance are paramount. Anesthetic goals encompass seizure and blood pressure control, hemodynamic stability, and intensive care support for potential complications. While eclampsia is a significant factor, seizures in pregnancy may arise from diverse causes, demanding early diagnosis and tailored treatment for optimal patient outcomes.
Co-Authors Andri Subiantoro Fitri, Wafa Sofia Indriani, Ratri Dwi Modjo, Annisa Afiyatushsholihah Rahman, Mafida Wida Ridho, Muhammad Ainur Rosyid Sania, Hen Subiantoro, Andri Sugiharto, Wahyu Zammara, Abdurrahman