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master's thesis
OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM
Rijeka: University of Rijeka, Faculty of Medicine, 2020. urn:nbn:hr:184:036054
Načinović, Tea
University of Rijeka
Faculty of Medicine
Department of Anaesthesiology,reanimatology and Intensive Care

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Načinović, T. (2020). OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM (Master's thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:036054

Načinović, Tea. "OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM." Master's thesis, University of Rijeka, Faculty of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:184:036054

Načinović, Tea. "OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM." Master's thesis, University of Rijeka, Faculty of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:184:036054

Načinović, T. (2020). 'OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM', Master's thesis, University of Rijeka, Faculty of Medicine, accessed 24 April 2024, https://urn.nsk.hr/urn:nbn:hr:184:036054

Načinović T. OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM [Master's thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2020 [cited 2024 April 24] Available at: https://urn.nsk.hr/urn:nbn:hr:184:036054

T. Načinović, "OSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM", Master's thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2020. Available at: https://urn.nsk.hr/urn:nbn:hr:184:036054

Metadata
TitleOSOBITOSTI ANESTEZIJE ZA DOVRŠENJE PORODA U TRUDNICA S PREEKLAMPSIJOM
Title (english)ANAESTHETIC MANAGAMENT FOR TERMINATION OF DELIVERY IN WOMEN WITH PREECLAMPSIA
AuthorTea Načinović
MentorVlatka Sotošek (mentor)
Committee memberŽeljko Župan (predsjednik povjerenstva)
Committee memberAlen Ružić (član povjerenstva)
Committee memberAlan Šustić (član povjerenstva)
GranterUniversity of Rijeka
Faculty of Medicine
(Department of Anaesthesiology,reanimatology and Intensive Care)
Rijeka
Defense date and country2020-07-17, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Gynecology and Obstetrics
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Anesthesiology and Reanimatology
Abstract
Preeklampsija je hipertenzivni poremećaj specifičan za trudnoću s prevalencijom u svijetu od 5 do 8%. Definirana je kao sindrom karakteriziran novonastalom hipertenzijom i proteinurijom, ili hipertenzijom uz pridružene znakove oštećenja ciljnih organa koji se očituju trombocitopenijom, bubrežnom insuficijencijom, nedostatnom jetrenom funkcijom, plućnim edemom te simptomima središnjeg živčanog, s ili bez proteinurije, nakon 20. tjedna trudnoće. Radi se o progresivnoj multisustavnoj bolesti koja predstavlja pravi izazov ne samo u okvirima porodništva već i anesteziološke prakse. Kod trudnica s preeklampsijom je nužna pravovremena anesteziološko evaluacija, a preporuča se već u ranom peripartalnom razdoblju zbog povećanog rizika za razvoj abrupcije posteljice, moždanog krvarenja, plućnog edema, akutne bubrežne ozljede, jetrenog zatajenja ili rupture, DIK-a te progresije do eklampsije. Općenito se preanesteziološka evaluacija temelji na procjeni dišnoga puta, hemodinamike i abnormalnosti zgrušavanja. Među anesteziološkim tehnikama analgezije, preferirana metoda je epiduralna analgezija. Prije aplikacije anestezije/analgezije, važno je reevaluirati čimbenike rizika za pojedinu trudnicu, poput višeplodne trudnoća, hipertenzije, prekomjerne debljine, očekivane otežane endotrahelana intubacija ili terapije antitromboliticima. Potreban je podroban nadzor (monitoring) majčinih vitalnih parametara i temeljita dokumentacija. Među terapijskim mjerama od posebnog je značaja antihipertenzivna terapija koja za ciljne vrijednosti krvnog tlaka uzima sistolički <160 mmHg te dijastolički <110 mmHg, premda u literaturi još nema preciznih smjernica. Naposljetku, u bolesnica s povećanim rizikom razvoja komplikacija, preporuča se profilaksa eklampsije magnezij sulfatom.
Abstract (english)
Preeclampsia is a hypertensive, pregnancy related disorder with world prevalence 5 to 8 %. The condition is characterized by the new onset of hypertension and proteinuria, or hypertension with associated signs of end-organ dysfunction such as thrombocytopenia, renal dysfunction, liver dysfunction, pulmonary edema or central nervous system damage, with or without proteinuria, after 20 weeks of pregnancy. It is a progressive multisystem disorder that is challenging for both obstetric clinician and anesthesiologist as well. With preeclamptic patients early anesthetic evaluation is mandatory; it is recommended early in peripartum period due to increased risk for developing placental abruption, brain hemorrhage, pulmonary edema, acute renal failure, liver dysfunction or rupture, DIC or progression to eclampsia. In laboratory findings in preeclamptic patients it is crucial to determinate thrombocyte count over time (TRC). In general, the preanesthesia evaluation focuses on airway evaluation, hemodynamic status and coagulation abnormalities. Among different anesthetic techniques of analgesia, preferred method is epidural analgesia. Before anesthesia/analgesia administration, it is necessary to reevaluate pregnancy related risk factors, such as multiparous pregnancy, hypertension, overweight, expected difficulty with endotracheal intubation or antitrombolytic therapy. Maternal vital signs should be monitored closely and well documented. Among medication measures antihypertensive therapy plays a key role. Blood pressure goals, although still not precisely supported by data, are <160 mmHg for systolic and <110 mmHg for diastolic blood pressure. Finnaly, magnesium sulphate for eclamptic seizures prevention is also recommended.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:184:036054
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2020-11-27 08:07:11