Manajemen Anestesi pada Pasien Obstetri dengan Kelainan Jantung Kongenital dan Risiko Hipertensi Pulmonal
Abstract
Jumlah ibu hamil dengan penyakit jantung saat ini meningkat tajam dikarenakan perbaikan daya tahan anak- anak yang lahir dengan masalah penyakit jantung kongenital. Hal ini dapat meningkatkan frekuensi faktor risiko kardiovaskular pada wanita usia subur dan penyakit kardiovaskular merupakan penyebab tersering kematian maternal di negara berkembang. Perubahan kardiovaskular selama kehamilan menambah beban dari penyakit pada ibu hamil dengan penyakit jantung dan dapat meningkatkan kejadian morbiditas dan mortalitas peripartum. Kehamilan merupakan problematika terkait kardiovaskular pada ibu hamil dengan hipertensi pulmonal. Perubahan anatomis dan fisiologis kardiovaskular selama kehamilan serta kelainan patologis jantung yang dimiliki harus menjadi pertimbangan dalam memilih mode persalinan dan pembiusan. Fase kritis terjadi pada saat persalinan dan pascapersalinan. Kondisi yang harus diperhatikan adalah menghindari peningkatan tahanan vaskular pulmonal, penurunan systemic vascular resistance (SVR), kelebihan cairan, nyeri, dan mencegah terjadinya sindrom Eisenmenger serta gagal jantung kanan.
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Jurnal Anestesi Obstetri Indonesia
