Anesthetic management for emergency cesarean section in a patient with status epilepticus: A case report

RATIONALE: The presence of clinically significant repeated maternal epilepsies during pregnancy increases the risk of adverse maternal, fetal and neonatal outcomes. However, there are few guidelines for anesthesiologists to deal with this situation. PATIENT CONCERNS AND DIAGNOSES: A 28-year-old primigravida was transferred to the operating room for emergency cesarean section. Based on the patient’s complaints and clinical appearance, provisional diagnosis of preeclampsia at 33 weeks’ gestation as well as frequent and repeated grand mal convulsions at 14 years of age were considered. The anesthetic modalities of the disease are also discussed. INTERVENTIONS AND OUTCOMES: Because the usual antiepileptic therapy had failed, the patient with status epilepticus underwent surgery under general anesthesia. The newborn was handed to the pediatrician and the patient was transferred to the intensive care unit for further observation and discharged 4 days later. No peri-operative or anesthetic complications were observed. LESSONS: Providing anesthesia to patients undergoing cesarean section poses major challenges for anesthesiologists. Close monitoring and proper treatment can help reduce risks for both the mother and baby.