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在一名患有垂体卒中的孕妇中克服麻醉挑战,该孕妇接受了经蝶窦垂体肿瘤内镜切除术。

Overcoming anaesthetic challenges in a pregnant woman with pituitary apoplexy undergoing endoscopic trans-sphenoidal resection of the pituitary tumour.

机构信息

Anaesthesia and Intensive Care, PGIMER, Chandigarh, India.

Anaesthesia and Intensive Care, PGIMER, Chandigarh, India

出版信息

BMJ Case Rep. 2023 May 29;16(5):e254299. doi: 10.1136/bcr-2022-254299.

Abstract

Pituitary apoplexy is a rare condition that occurs due to acute haemorrhage in the pituitary gland and usually presents with features of acute hypopituitarism, visual defects and ophthalmoplegia. Pregnancy is one of the risk factors for pituitary apoplexy. Medical management is the first line of management in pregnancy irrespective of the gestational age. However, acute neuro-ophthalmological deterioration might warrant an urgent surgical decompression. Preoperative corticosteroids have dual benefits of providing hormonal replacement in the mother and also promoting fetal lung maturity in the offspring. Uterine contractions should be monitored and tocolysis provided as per requirements in a post-viable fetus.

摘要

垂体卒中是一种罕见的疾病,由于垂体腺内急性出血而发生,通常表现为急性垂体功能减退、视力缺陷和眼肌麻痹。妊娠是垂体卒中的一个危险因素。无论妊娠周数如何,在妊娠期间,医学管理都是一线治疗方法。然而,急性神经眼科恶化可能需要紧急手术减压。术前皮质类固醇具有双重益处,既能为母亲提供激素替代,也能促进胎儿肺成熟。应监测子宫收缩,并根据有活力胎儿的需要给予宫缩抑制剂。

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