Perioperative Management in Parturient with Severe Preeclampsia, Obesity, and COVID-19

Rafael Bagus Yudhistira (Tugu Koja Hospital, Jakarta Utara, Indonesia)
Muhammad Yurizar Yudhistira (Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia)
Raden Theodorus Supraptomo (Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia)

Solo Journal of Anesthesi, Pain and Critical Care
Vol 1, No 2 (2021): October 2021

The elevated cases of pregnant women infected with COVID-19 who needed to undergo caesarean section is a great challenge to anesthesiologists. Morbid obesity and preeclampsia in pregnancy are also another challenge to medical practice especially when the patient requires caesarean section. To describe the perioperative management of a morbidly obese preeclamptic patient with COVID-19. A pregnant woman with mild case of COVID-19, severe preeclampsia and obesity underwent an emergency caesarean section. Spinal anesthesia was performed using a Whitacre 26G spinal needle with 76 mm length, bupivacaine 0.5% 12.5 mg as spinal anesthesia agent and fentanyl 25 mcg as adjuvant. All operating teams use PPE according to COVID-19 guidelines and standard procedures. The operation went with a good outcome without any transmission to the operating team. The patient underwent treatment without postoperative complications. Spinal anesthesia is considered safe to be a usual technique for parturient with preeclampsia and morbid obesity. A proper COVID-19 surgery protocol is crucial in order to protect health workers handling COVID-19 patients.