الفهرس | Only 14 pages are availabe for public view |
Abstract I n this Research the anesthetic management of the pregnant having an intracranial space occupying lesion is studied. The physiology of the pregnant patient differs from that of the Non-pregnant. Brain tumors and pregnancy; each of which affects the other as pregnancy increases the size, vascularity, edema of some brain tumors, and also some brain tumors can cause disruption of the hormonal cycle which may leads to early termination of pregnancy. Also, we give a hint about aneurysms and arteriovenous malformations and the safe anesthetic techniques if they coexist with pregnancy. Conclusion: A multidisciplinary and cooperative approach of the neurosurgeon, anesthesiologist, obstetrician and neonatologist are required during management of the pregnant patient with an intracranial space occupying lesion to ensure a successful outcome. fetal and maternal well-being mainly depend on maintenance of hemodynamic stability and avoidance of aortocaval compression, hypoxemia and hypercarbia. For patients in 2nd early 3rd trimester, it is possible to perform the Neurosurgical operation first and complete pregnancy to full term. Patients at 34 weeks or more gestation, cesarian section followed by neurosurgical operation is recommended. For patient in the 1st trimester, it is advisable to terminate pregnancy to allow safe management. In postoperative management attention should be paid to adequate analgesia, Antiemesis and thromboprophylaxis. Some Benign tumors’ symptoms improve with corticosteroids, so pregnancy can be completed and Neurosurgical intervention can be done later on. |