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Infarto isquémico peripartum agudo durante la analgesia epidural
Ivan Šklebar1,2,3, Tanja Goranović4,5, Jasna Čerkez Habek6,2
1University Department of Anesthesiology, Reanimatology and Intensive Care Medicine, and Pain Treatment, University Hospital Center Zagreb, Zagreb, Croatia.
Zeitschrift fur Geburtshilfe und Neonatologie
|September 1, 2025
Resumen
Se produjo un accidente cerebrovascular peripartum pontino raro en una mujer que recibía analgesia epidural. La intervención obstétrica rápida y el tratamiento posparto condujeron a la recuperación de la madre y a un bebé sano, lo que pone de relieve la importancia de la gestión oportuna de las complicaciones.
Área de la Ciencia:
- Neurología
- Obstetricia y parto
- Anestesiología
Sus antecedentes:
- El accidente cerebrovascular periparto es una complicación rara pero grave.
- La analgesia epidural rara vez puede conducir a complicaciones como hipotensión y shock espinal.
- El accidente cerebrovascular de Pontine presenta diversos síntomas neurológicos.
Objetivo del estudio:
- Para reportar un raro caso de accidente cerebrovascular en el periparto.
- Discutir las posibles causas y el tratamiento de esta complicación.
- Para hacer hincapié en la importancia de la intervención obstétrica rápida.
Principales métodos:
- Informe del caso de un primipara de 34 años.
- Tratamiento inicial del choque espinal y la bradicardia fetal.
- El diagnóstico incluye una resonancia magnética cerebral.
- Tratamiento con ácido acetilsalicílico y fisioterapia.
- Investigación postparto para la trombofilia.
Principales resultados:
- Un bebé sano nació por extracción al vacío después de la estabilización materna.
- Lesión isquémica pontina confirmada por resonancia magnética en el día 3 postparto.
- Los síntomas neurológicos se resolvieron gradualmente con el tratamiento.
- Trombofilia detectada después del parto.
- La paciente fue dada de alta el día 17 después del parto.
Conclusiones:
- La intervención obstétrica rápida es crucial en el manejo de las complicaciones peripartum maternas y fetales.
- El ictus pontino puede ocurrir secundario a la hipotensión severa durante la analgesia epidural.
- El diagnóstico precoz y la gestión multidisciplinaria mejoran los resultados.
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