Anaesthetic management of an emergency caesarean section in a complex immunologically compromised patient with pre-eclampsia and multifactorial thrombocytopaenia

Anaesthesia Reports
A JudgeC McCaul

Abstract

A 35-year-old gravida 3, para 0 woman required an emergency caesarean section for pre-eclampsia with severe features including a platelet count of 7 × 109.l-1. The patient's thrombocytopaenia was an acute on chronic presentation. In addition to pre-eclampsia, the patient had a complex background history which included autoimmune lymphoproliferative syndrome, the manifestations of which include autoimmune cytopaenias and recurrent infections. The patient also had common variable immune deficiency and acquired C1-esterase inhibitor deficiency which may cause life-threatening angioedema, including of the airway. In this report, we describe the potential anaesthetic challenges posed by this pre-eclamptic, immunologically compromised patient with severe thrombocytopaenia and the potential for difficult airway, and how these were addressed in a safe and timely manner. Specifically, we highlight the important considerations when performing a general anaesthetic in this unique combination of circumstances. Although the patient's conditions are rare, this case demonstrates that early multidisciplinary team input can help successfully guide the management of medically complex pregnant patients.

References

Jun 1, 1995·Anaesthesia·M Cox, A Holdcroft
Jun 7, 2005·International Journal of Obstetric Anesthesia·R J Griffiths, G O'Sullivan
Mar 9, 2006·Hematology·V Koneti Rao, Stephen E Straus
Sep 18, 2014·International Journal of Women's Health·Teresa CaballeroRosario Cabañas
Oct 11, 2014·The Journal of Obstetrics and Gynaecology Research·Simona PattiRoberto Brunelli
Jan 21, 2016·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Yurina KametaYukihiro Terada

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Related Papers

The British Journal of Clinical Practice
Y C Chia, S J Machin
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
Kjell HaramJouko Pirhonen
© 2021 Meta ULC. All rights reserved