ASUHAN KEPERAWATAN INTRA ANESTESI PADA KASUS EMBOLI KETUBAN DENGAN FAKTOR PREDISPOSISI PLASENTA PREVIA

Abstract

Amniotic fluid embolism (AFE) is a rare but high-risk acute obstetric complication that can lead to maternal mortality. This condition can be triggered by various predisposing factors, one of which is placenta previa, which increases the likelihood of amniotic fluid entering the maternal circulation. This study aims to report on intraoperative anesthesia management in patients with amniotic fluid embolism who have a history of placenta previa through the rapid response of the anesthesia team, consisting of intubation, maximum oxygen administration, and vasopressors. Case study design with clinical description of patients  who experienced amniotic fluid embolism while undergoing elective cesarean section due to placenta previa with the Society for Maternal-Fetal Medicine and AHA 2020 version. The results found that patients  experienced cardiovascular collapse and acute respiratory failure due to amniotic fluid embolism after fetal extraction. This requires rapid and appropriate management, including rapid intubation, fluid resuscitation, administration of vasopressors, and ventilator support. The diagnosis of amniotic fluid embolism was clinically confirmed. Rapid intra-anesthetic management allowed the patient to survive and recover. In conclusion, placenta previa can be a significant risk factor for amniotic fluid embolism. Prompt and timely intra-anesthetic management is key to saving the patient's life, including endotracheal intubation, mechanical ventilation with FiO2 100%, high-quality CPR, fluid resuscitation, administration of vasopressors (adrenaline and norepinephrine), and ECG monitoring.