LAPORAN KASUS: MANAJEMEN PREEKLAMSIA BERAT DENGAN KARSINOMA OVARIUM STADIUM LANJUT

Abstract

Preeclampsia is a disorder in pregnancy that is associated with hypertension, occurring after more than 20 weeks of gestation and often approaching full-term gestational age. The pathophysiology of preeclampsia involves angiogenic and anti-angiogenic factors. Carcinoma is one of the leading causes of death worldwide. This case report aims to determine the management of severe preeclampsia with ovarian carcinoma. The research was conducted in the Obstetrics and Gynecology Department of Arifin Achmad Regional Hospital, Riau. Data was taken retrospectively from medical records in 2021. Management of ovarian carcinoma during pregnancy is challenging because it affects the reproductive organs where the fetus develops, especially women with preeclampsia. The severe preeclampsia that occurred in this patient was probably a preeclampsia-like syndrome triggered by ovarian carcinoma.This patient immediately underwent incological surgery for abdominal termination because she met the criteria for termination of pregnancy, namely 36 weeks. The patient was treated with MgSO4 and nifedipine and immediately underwent a Caesarean section and was discharged ± 500 cc of yellow ascitic fluid and tumor seeds were found in the lower segment of the uterus. A semilunar incision is made in the lower uterine segment that is free of tumor seeds. Treatment of carcinoma during pregnancy must balance the health of the mother and fetus. Treatment in the form of oncological surgery can be carried out at any time during pregnancy if indicated. Chemotherapy can be started in the second and third trimesters. The severe preeclampsia that occurred in this patient was probably a preeclampsia-like syndrome triggered by ovarian carcinoma.