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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12710/27100
Title: Obstetrical anesthesia for a patient with multiple sclerosis: case report and literature review
Authors: Plămădeală, Svetlana
Coloman, Dmitri
Ciubara, Roman
Belîi, Natalia
Keywords: multiple sclerosis;epidural anesthesia;cesarian delivery;high-risk pregnancy
Issue Date: 2024
Publisher: Instituţia Publică Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” din Republica Moldova
Citation: PLĂMĂDEALĂ, Svetlana, COLOMAN, Dmitri, CIUBARA, Roman, BELÎI, Natalia. Obstetrical anesthesia for a patient with multiple sclerosis: case report and literature review. In: Revista de Științe ale Sănătății din Moldova = Moldovan Journal of Health Sciences. 2024, nr. 1(11), pp.66 -71. ISSN 2345-1467. https://doi.org/10.52645/MJHS.2024.1.10
Abstract: Introduction. Multiple sclerosis is an autoimmune disease characterized by chronic inflammation with progressive demyelination and axonal dysfunction. The disease affects about 1 million young adults, 2/3 of which are women of childbearing age, with all patients develop irreversible neurological dysfunction. There is observed a stagnation of the disease during pregnancy, with the return of exacerbations in the postpartum period. Contemporary specialty textbooks neither confirm nor deny the safety of neuraxial anesthesia in patients with central nervous system diseases. Clinical case. We present the clinical case of a 25-year-old nullipara pregnant (36 weeks and 6 days gestation age), known with relapsing-remitting multiple sclerosis and epilepsy. The woman has relapsing multiple sclerosis symptoms during last 6 days, reason why is urgently consulted by the anesthesiologist for cesarean delivery. Management and outcome. The article describes the technique of epidural anesthesia for the obstetrical patient with multiple sclerosis and the course of the perianesthetic evolution, including 1-year follow-up after cesarean section. Discussions. With the aim of avoiding potential influences on the evolution and progression of the disease, clinical judgment and the choice of anesthetic technique (general vs. neuraxial) depends on several factors: vaginal delivery or caesarean section, the presence of contextual clinical modifiers (native or drug-induced coagulopathy, infection), the urgency of the intervention, and the patient’s cooperation. In case of parturients with multiple sclerosis, all the risks should be rigorously evaluated: on one hand - the additional risk of general anesthesia (risk of aspiration, potential loss of airway control, critical desaturations) and on the other hand - the risk of hypothetical local anesthetic toxicity in the case of neuraxial techniques. Conclusion. Neuraxial epidural anesthesia is a safe technique in obstetric patients with multiple sclerosis.
metadata.dc.relation.ispartof: Revista de Științe ale Sănătății din Moldova = Moldovan Journal of Health Sciences
URI: https://doi.org/10.52645/MJHS.2024.1.10
https://cercetare.usmf.md/sites/default/files/inline-files/Svetlana%20Pl%C4%83m%C4%83deal%C4%83%2C%20Dmitri%20Coloman%2C%20Roman%20Ciubara%2C%20Natalia%20Bel%C3%AEi%20Obstetrical%20anesthesia%20for%20a%20patient%20with%20multiple%20sclerosis%20case%20report%20and%20literature%20review.pdf
http://repository.usmf.md/handle/20.500.12710/27100
ISSN: 2345-1467
Appears in Collections:Revista de Științe ale Sănătății din Moldova : Moldovan Journal of Health Sciences 2024 nr. 1(11)



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