"Dilemma 2:1" neurotransmitter revisited - a case report on myasthenia crisis and its implications on a postpartal patient with placenta previa totalis / Martin Isidro M. Capucion.

By:

Capucion, Martin Isidro M., MD [author]

Language: English Publication details: Fairview, Quezon City Department of Obstetrics and Gynecology, FEU-NRMF, 2018Description: photos (black and white); (in folder)Content type:

rdacontent

Media type:

rdamedia

Carrier type:

rdacarrier

LOC classification:

OB20180001

Summary: ABSTRACT: Obstetrical Hemorrhage is one of the major causes of maternal mortality in the Philippines. There are different clinical circumstances in which risks for obstetricalhemorrhage may ensue, one of which abnormal placentation. In Placenta Previa The Latin previa means going before-and in this sense, the placenta goes before the fetus into birth canal. In obstetrics, placenta previa describes a placenta that is implanted somewhere in the lower uterine segment, either over or very near the internal cervical os. Sequelae include the potential for severe bleeding and preterm birth as well as the need for cesarean delivery. We are presented with a case of 31 year old, Gravida 2 Para 1 (1000); Pregnancy Uterine 36 weeks and 4 days with known history of Myasthenia Gravis for 8 years who came in with a subjective complaint of hypogastric pain associated with profuse vaginal bleeding. The patient was subsequently recovering in the Post Anesthetic Care Unit, when she suddenly experienced difficulty of breathing with bulbar edema and generalized edema of the extremities. Patient then was transferred to Intensive care unit for mechanical ventilation due to myasthenic crisis. Acute respiratory failure is one of the life threatening complications that may be encountered with Myathenia Gravis. Prompt evaluation and a multidisiplinary approach is essential in decreasing the mortality of postpartal woman with such case. Prompt recognition of imppending respiratory paralysis is the key to successful management. A good outcome depends on meticulous maternal and fetal prenatal surveillance and early detection and mangement of exacerbations. Facilities and trained personnel must be available to support labor and manage vaginal or operative delivery. Intensive care of Myasthenic crises is critical to the prevention of maternal complications and death.

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Holdings
Item type	Current library	Call number	Status	Date due	Barcode
Research	Far Eastern University - Nicanor Reyes Medical Foundation Research	OB20180001 (Browse shelf(Opens below))	Available		R000599

Includes bibliographical references.

ABSTRACT: Obstetrical Hemorrhage is one of the major causes of maternal mortality in the Philippines. There are different clinical circumstances in which risks for obstetricalhemorrhage may ensue, one of which abnormal placentation. In Placenta Previa The Latin previa means going before-and in this sense, the placenta goes before the fetus into birth canal. In obstetrics, placenta previa describes a placenta that is implanted somewhere in the lower uterine segment, either over or very near the internal cervical os. Sequelae include the potential for severe bleeding and preterm birth as well as the need for cesarean delivery. We are presented with a case of 31 year old, Gravida 2 Para 1 (1000); Pregnancy Uterine 36 weeks and 4 days with known history of Myasthenia Gravis for 8 years who came in with a subjective complaint of hypogastric pain associated with profuse vaginal bleeding. The patient was subsequently recovering in the Post Anesthetic Care Unit, when she suddenly experienced difficulty of breathing with bulbar edema and generalized edema of the extremities. Patient then was transferred to Intensive care unit for mechanical ventilation due to myasthenic crisis. Acute respiratory failure is one of the life threatening complications that may be encountered with Myathenia Gravis. Prompt evaluation and a multidisiplinary approach is essential in decreasing the mortality of postpartal woman with such case. Prompt recognition of imppending respiratory paralysis is the key to successful management. A good outcome depends on meticulous maternal and fetal prenatal surveillance and early detection and mangement of exacerbations. Facilities and trained personnel must be available to support labor and manage vaginal or operative delivery. Intensive care of Myasthenic crises is critical to the prevention of maternal complications and death.

Research - Department of Obstetrics & Gynecology

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