Manajemen Anestesi pada Seksio Sesarea dengan Idiopathic Thrombocytopenic Purpura: Serial kasus - Achmad Haryanto; Ruddi Hartono; Isngadi Isngadi (Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC), 2021)
Trombositopenia merupakan perubahan hemostasis yang umum terjadi pada wanita hamil, namun jarang ditemukan kondisi berat. Idiopathic thrombocytopenic purpura (ITP) merupakan salah satu penyebab trombositopenia pada wanita hamil. ITP ditandai dengan peningkatan penghancuran trombosit oleh antibodi immunoglobulin G (IgG) yang dapat meningkatkan risiko perdarahan pada pasien dan fetus. Kami melaporkan tiga kasus wanita hamil dengan ITP yang akan dilakukan tindakan seksio sesarea. Satu pasien menjalani seksio sesarea emergency dengan trombosit 4000 dan dua pasien menjalani seksio sesarea elektif. Pasien seksio sesarea elektif diberikan transfusi trombosit perioperatif terlebih dahulu. Ketiga pasien menjalani prosedur seksio sesarea dengan teknik anestesi general. Pemantauan perdarahan dilakukan selama sampai dengan setelah operasi. Kondisi postoperatif pasien baik dan dirawat di ruang intensive care unit (ICU). Case Series: Anesthesia Management in Caesarean Section with Idiopathic Thrombocytopenic Purpura Abstract Thrombocytopenia is the most common hemostatic change in pregnancy, but severe thrombocytopenia is rare. One of the causes, idiopathic thrombocytopenic purpura (ITP), is characterized by increased platelet destruction by immunoglobulin G (IgG) antibodies, presenting a high risk of hemorrhage for the patient, but also the fetus, since antibodies may cross the placenta. We report three cases of pregnant women with ITP undergoing cesarean section. One patient underwent emergency cesarean section with a platelet of 4000 and two patients underwent elective cesarean. Patients with elective cesarean section were given the first perioperative platelet transfusion. The cesarean section procedures were performed under general anesthesia. Bleeding monitoring is carried out during up to after surgery.