Hypoglicemia in cesarian section

Lazarevski, Martin and Zikova, Radmila and Mihailova, Ana and Delipetrova, Natali and Mojsova, Maja and Trojikj, Tatjana and Eftimova, Biljana (2021) Hypoglicemia in cesarian section. In: Current topics in anesthesiology 2021. (Submitted)

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Abstract

Introduction Gestational diabetes is a metabolic disorder which develops often in the second or third trimester and disappears after giving birth in most cases. Hypoglycemia is an acute complication of gestational diabetes and is an urgent situation where early recognition and adequate treatment are essential for saving the mothers and the newborn life. However, recognizing the signs of hypoglycemia is more difficult in patients with deep sedation or general anesthesia.

Material and Methods Case of 28 years old pregnant woman who was admitted in hospital with uterine contractions. It was the second pregnancy for the patient. In the first pregnancy, gestational diabetes was diagnosed, but it was badly regulated. Now, during the second pregnancy, insulin therapy was added, but the patient didn’t use the therapy regularly again. Preoperative glucose level was 9,6 mmol/l. The emergency cesarean section was performed in spinal anesthesia. When the surgeon started, the patient felt pain and ketamine 20mg i.v. was given. The patient was hemodynamicly stable during the surgery. The newborn baby was with Apgar score of 8-9. After removing of the placenta, the patient started with hemodynamic destabilization, with tachycardia, hypotension, dyspnea, pale skin and dry mouth. Because of ketamine administration before, there was no verbal contact with the patient. Immediately after that glycaemia was measured and the glucose level was 2,1 mmol/l. Hypoglycemia was corrected with 40 ml of Dextrose 35%. Dextrose 5%, colloids and 5 mg of ephedrine was administered for increasing on the blood pressure. The patient was transferred in ICU and the next day when the glycaemia was regulated she was transferred in the obstetric department.

Conclusion – This case report needs to show that the perioperative patient monitoring and the recognition of early clinical signs are essential for preventing and handling with the possible complications.

Key words – Gestational diabetes, cesarean section, hypoglycemia, obstetric anesthesia.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Assoc.Prof Biljana Eftimova
Date Deposited:	11 Mar 2022 10:36
Last Modified:	22 Jun 2022 09:29
URI:	https://eprints.ugd.edu.mk/id/eprint/29590

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