Sudden and unexpected seizure during emergency cesarean section in a nonhypertensive hypothyroid primigravida

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
J. Kausik, D. Divya, S. Parthasarathy
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引用次数: 0

Abstract

A 29-year-old primigravida parturient at term with a known case of hypothyroidism for the past 1 year was taken for emergency cesarean section in view of fetal distress. The patient's medical history showed a history of galactorrhea, for which magnetic resonance imaging of the brain and the routine blood investigations were normal. The parturient was posted for emergency cesarean section due to fetal distress. There was no significant comorbid illness or illicit drug intake. All the basic investigations including the thyroid-stimulating hormone were normal. Spinal anesthesia with 2.0 ml of 0.5% hyperbaric bupivacaine to achieve a level of T6 was performed. After the delivery of the fetus, there was a sudden seizure occurred, and the mother lost her consciousness. The hemodynamics remained stable. The patient was given oxygen, 2 mg of intravenous midazolam, and magnesium sulfate by the Pritchard regimen. The newborn's Apgar scores were normal. She had no recollection of the seizure attack after regaining consciousness and normal spontaneous respiration which occurred in a few minutes. Breastfeeding was recommended. To avoid another seizure episode, the Pritchard regimen was followed. The recovery period was uneventful. A cranial computed tomography scan of the brain was also performed, which revealed no abnormalities. Serum electrolytes were within the normal range when tested again. This case is being reported to raise awareness of seizures in nonhypertensive patients.
一例非高血压甲状腺功能减退的初产妇在紧急剖宫产过程中突然和意外癫痫发作
一名29岁的初产产妇,在过去一年中已知甲状腺功能减退,鉴于胎儿窘迫,被紧急剖宫产。患者的病史显示有溢乳史,脑部磁共振成像和血液常规检查正常。由于胎儿窘迫,产妇被安排进行紧急剖宫产。没有明显的合并症或非法药物摄入。包括促甲状腺激素在内的所有基础检查均正常。用2.0毫升0.5%高压布比卡因进行脊髓麻醉,达到T6水平。胎儿分娩后,突然发作,母亲失去了意识。血流动力学保持稳定。患者通过Pritchard方案接受氧气、2 mg咪唑安定静脉注射和硫酸镁治疗。新生儿的Apgar评分正常。她不记得在几分钟内恢复意识和正常自主呼吸后发作的情景。建议母乳喂养。为了避免再次发作,采用了Pritchard方案。恢复期波澜不惊。还进行了脑部计算机断层扫描,没有发现异常。再次检测时,血清电解质在正常范围内。据报道,该病例旨在提高非高血压患者对癫痫发作的认识。
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来源期刊
Indian Journal of Medical Specialities
Indian Journal of Medical Specialities MEDICINE, GENERAL & INTERNAL-
自引率
16.70%
发文量
51
期刊介绍: The Indian Journal of Medical Specialities is an all-encompassing peer-reviewed quarterly journal. The journal publishes scholarly articles, reviews, case reports and original research papers from medical specialities specially pertaining to clinical patterns and epidemiological profile of diseases. An important highlight is the emphasis on undergraduate and postgraduate medical education including various aspects of scientific paper-writing. The journal gives priority to research originating from the developing world, including from the tropical regions of the world. The journal also publishes special issues on health topics of current interest. The Indian Journal of Medical Specialities is one of the very few quality multispeciality scientific medical journals.
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