RÉSUMÉ
Esophageal atresia (EA), often regarded as 'the epitome of modern surgery', typically presents with tracheoesophageal fistula (TEF) and occurs in about 1 in 2400 to 1 in 3000 newborns, frequently accompanied by other congenital malformations. Rarely, EA is associated with congenital esophageal stenosis (CES), a condition first identified by Spitz. EA and TEF result from the incomplete development of the esophagus and trachea, with polyhydramnios in the third trimester being a potential indicator. This case study described a 43-year-old multiparous woman who, during an antenatal care examination, was found to have a fetus with abnormalities and excessive amniotic fluid, necessitating two amnioreduction procedures. Despite the interventions, the fetus exhibited signs of supra-esophageal atresia, leading to an elective cesarean section. The newborn, a girl with a birth weight of 3200 grams and an Apgar score of 5/6, could not be fitted with an orogastric tube, although karyotyping showed no chromosomal abnormalities. The discussion highlights the association of EA with various tracheobronchial anomalies and emphasizes the need for preserving the native esophagus in cases of CES. Gastroesophageal reflux disease (GERD) is common in EA patients, often requiring long-term follow-up and possible antireflux surgery. The case underscores the importance of diligent monitoring and intervention in high-risk pregnancies, with regular ANC examinations and accurate diagnoses being crucial for effective management.
RÉSUMÉ
The health of both the mother and the fetus is at risk when symptomatic maternal arrhythmias occur during pregnancy. Sustained symptomatic arrhythmias should be managed, much like in the non-pregnant population. The specific arrhythmia that has been identified or is suspected must be treated. Electrical cardioversion is used to treat supraventricular arrhythmias when medication therapy and physical therapy, such as sinus carotid massage or valsalva movements, fail or in life-threatening conditions where the patient is hemodynamically unstable. A 27-year-old primipara came to Bengkalis hospital at 37 weeks of gestation due to complaints of palpitations. palpitations felt for 4 hours before admission to the hospital. The patient had experienced the same complaint and was examined by a cardiologist who said that the patient had a tendency to arrhythmia and was given bisoprolol. An ECG examination was carried out in the emergency room, the impression was supraventricular tachycardia with HR 185 bpm, an abdominal termination of pregnancy was carried out, and the cardiologist performed cardioversion in the operating room 3 times, and the mother's HR returned to sinus rhythm. The outcome was a baby girl born with a birth weight of 3200 grams, an Apgar score of 8/9. Mother was treated and went home on the 3rd postoperative day in good condition. Provided that a multidisciplinary approach, continuous fetal heart rate monitoring and the possibility to perform a caesarean section are applied, it can be concluded that cardioversion is a safe and effective treatment for maternal tachycardia in pregnancy.