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Article: Anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsia

TitleAnesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsia
Authors
Issue Date2004
PublisherCanadian Anesthesiologists' Society. The Journal's web site is located at http://www.cja-jca.org/
Citation
Canadian Journal Of Anesthesia, 2004, v. 51 n. 9, p. 923-927 How to Cite?
AbstractPurpose: To describe the anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe preeclampsia. Clinical features: A 28-yr-old parturient with a history of thrombocytopenia was admitted with signs of pre-eclampsia (blood pressure of 140/90 mmHg, heavy proteinuria and moderate bilateral ankle edema) at 25 weeks of gestation. Laboratory studies revealed pancytopenia (hemoglobin 6.4 g·L-1, white cell count 3.43 × 109·L-1, platelet count 20 × 109·L-1) and bone marrow biopsy showed hypoplastic anemia. As pre-eclampsia worsened, a Cesarean delivery was performed at 27 weeks with prophylactic platelet transfusion and meticulous blood pressure control. The procedure was uneventful, conducted under general anesthesia with an estimated blood loss of around 600 mL and a live female baby was delivered. Postoperatively her blood pressure and neurological symptoms improved but thrombocytopenia remained at discharge. Conclusions: Hypoplastic anemia is rare in pregnancy but it poses an increased risk for both mother and fetus. The mother is at risk of life-threatening episodes of bleeding and infection and a multidisciplinary team approach (obstetrician, anesthesiologist, hematologist and pediatrician) is essential. An accurate assessment of the hematological condition should be made and abnormalities corrected before surgery. Regional anesthesia may not be possible in this circumstance.
Persistent Identifierhttp://hdl.handle.net/10722/147208
ISSN
2015 Impact Factor: 2.139
2015 SCImago Journal Rankings: 0.884
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, AYCen_US
dc.contributor.authorChan, RSNen_US
dc.contributor.authorIrwin, MGen_US
dc.date.accessioned2012-05-29T06:00:47Z-
dc.date.available2012-05-29T06:00:47Z-
dc.date.issued2004en_US
dc.identifier.citationCanadian Journal Of Anesthesia, 2004, v. 51 n. 9, p. 923-927en_US
dc.identifier.issn0832-610Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/147208-
dc.description.abstractPurpose: To describe the anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe preeclampsia. Clinical features: A 28-yr-old parturient with a history of thrombocytopenia was admitted with signs of pre-eclampsia (blood pressure of 140/90 mmHg, heavy proteinuria and moderate bilateral ankle edema) at 25 weeks of gestation. Laboratory studies revealed pancytopenia (hemoglobin 6.4 g·L-1, white cell count 3.43 × 109·L-1, platelet count 20 × 109·L-1) and bone marrow biopsy showed hypoplastic anemia. As pre-eclampsia worsened, a Cesarean delivery was performed at 27 weeks with prophylactic platelet transfusion and meticulous blood pressure control. The procedure was uneventful, conducted under general anesthesia with an estimated blood loss of around 600 mL and a live female baby was delivered. Postoperatively her blood pressure and neurological symptoms improved but thrombocytopenia remained at discharge. Conclusions: Hypoplastic anemia is rare in pregnancy but it poses an increased risk for both mother and fetus. The mother is at risk of life-threatening episodes of bleeding and infection and a multidisciplinary team approach (obstetrician, anesthesiologist, hematologist and pediatrician) is essential. An accurate assessment of the hematological condition should be made and abnormalities corrected before surgery. Regional anesthesia may not be possible in this circumstance.en_US
dc.languageengen_US
dc.publisherCanadian Anesthesiologists' Society. The Journal's web site is located at http://www.cja-jca.org/en_US
dc.relation.ispartofCanadian Journal of Anesthesiaen_US
dc.subject.meshAdulten_US
dc.subject.meshAnemia, Hypoplastic, Congenital - Complications - Therapyen_US
dc.subject.meshAnesthesia, Generalen_US
dc.subject.meshAnesthesia, Obstetricalen_US
dc.subject.meshBlood Pressure - Drug Effectsen_US
dc.subject.meshCesarean Sectionen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshNifedipine - Therapeutic Useen_US
dc.subject.meshPlatelet Transfusionen_US
dc.subject.meshPre-Eclampsia - Complications - Drug Therapyen_US
dc.subject.meshPregnancyen_US
dc.subject.meshPregnancy Complications, Hematologic - Therapyen_US
dc.subject.meshVasodilator Agents - Therapeutic Useen_US
dc.titleAnesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsiaen_US
dc.typeArticleen_US
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_US
dc.identifier.authorityIrwin, MG=rp00390en_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid15525619-
dc.identifier.scopuseid_2-s2.0-12344275751en_US
dc.identifier.hkuros97321-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-12344275751&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume51en_US
dc.identifier.issue9en_US
dc.identifier.spage923en_US
dc.identifier.epage927en_US
dc.identifier.isiWOS:000225325000014-
dc.publisher.placeCanadaen_US

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