Anaesthetic Management for Caesarean Delivery Patient with Obstructed Superior Vena Cava by Mediastinal Mass
Vanda Pattaratuma MD*, Theerada Chandee MD**, Narongkorn Saiphoklang MD***
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand ** Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand *** Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Maternal anatomical and physiological changes occur during pregnancy, particularly with cardiovascular and respiratory systems. Pregnant women with large mediastinal mass additionally have an increased risk of cardiopulmonary compromise. We report a 31-year-old patient at 30 weeks of gestation with a large anterior mediastinal tumour with superior vena cava obstruction. Her presenting symptom was progressive and severe dyspnea due to the large mediastinal mass. An ultrasound-guided biopsy was performed and the pathologic result was Hodgkin’s lymphoma. Termination of pregnancy and delivery of the neonate were performed using a Caesarean delivery under spinal anesthesia in the sitting position. The perioperative anaesthetic management was successful without any serious complications, and the postoperative outcomes were very impressive.
Keywords : Anesthesia, Mediastinal mass, Hodgkin lymphoma, Spinal, Caesarean section
