Multipl Skleroz’lu Gebede Anestezi Yöntemi
Özet
Multipl skleroz (MS), beyni, omuriliği ve optik sinirleri etkileyen; beyin ve spinal kordda inflamasyon, demiyelinizasyon ve aksonal hasarla karakterize otoimmün bir hastalıktır (1). MS tipik olarak tek taraflı optik nörit, kısmi miyelit, duyu bozuklukları veya birkaç gün içinde gelişen internükleer oftalmopleji gibi beyin sapı sendromları ortaya çıkar. Genç yaşlarda (20-30 yaş) ortaya çıkar ve fiziksel sakatlığa, bilişsel bozulmaya ve yaşam kalitesinin düşmesine neden olabilir. MS kadınlarda daha sık görülür (%70), son 30 yılda yetişkin kadın ve erkekler arasındaki MS oranı 2:1'den 3:1'e çıkmıştır. MS ağırlıklı olarak üreme çağındaki kadınları etkilediği için tanı konulduktan sonra kadınların %30'a varan bir kısmı çocuk sahibi olmaktadır (2). MS semptomları, stres, emosyonel değişim, vücut ısısı değişiklikleri, cerrahi, anestezi gibi nedenlere bağlı olarak artmakta ve remisyondaki hastada yeni ataklara yol açabilmektedir. Olgumuz 31 yaşında 6 yıldır MS tedavisi gören son 2 yıldır remisyonda olan 39 haftalık nullipar gebe ve genel anestezi yaklaşımı literatür eşliğinde sunmayı amaçladık.
Multiple Sclerosis (MS) is an autoimmune disease that affects the brain, spinal cord, and optic nerves, characterized by inflammation, demyelination, and axonal damage in the brain and spinal cord (1). MS typically presents with brainstem syndromes such as unilateral optic neuritis, partial myelitis, sensory disturbances, or internuclear ophthalmoplegia developing within a few days. It onset occurs at young ages (20–30 years) and can lead to physical disability, cognitive impairment, and a decreased quality of life. MS is more common in women (70%), and over the last 30 years, the ratio of MS between adult women and men has increased from 2:1 to 3:1. Since MS predominantly affects women of reproductive age, up to 30% of women have children after diagnosis (2). MS symptoms increase due to causes such as stress, emotional changes, body temperature fluctuations, surgery, and anesthesia, which can lead to new relapses in patients who are in remission. We aimed to present a 31-year-old, 39-week nulliparous pregnant patient who has been receiving MS treatment for 6 years and has been in remission for the last 2 years, along with the general anesthesia approach in light of the literature.
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