Peri-operative management of a pregnant patient with hereditary angioedema submitted to a cesarean-section: Case report

We describe a successful case of a pregnant patient with type I hereditary angioedema submitted to a C-section.ResumoO angioedema hereditário é uma doença autossômica dominante, que se manifesta por crises súbitas, recorrentes e de gravidade variável de edema subcutâneo e submucoso, que podem ocorrer espontaneamente ou em resposta a gatilhos. São conhecidos três tipos de angioedema hereditário. A doença é condicionada por diminuição do nível plasmático ou alteração da capacidade funcional do inibidor de C1, com aumento da bradicinina e da permeabilidade vascular, com consequente edema. Várias medidas devem ser tomadas no período peri-operatório de forma a evitar uma crise aguda. A profilaxia deverá ser realizada durante a gravidez antes de qualquer procedimento cirúrgico, antes de procedimentos dentários, quando existe manuseamento da via aérea, nos doentes com episódios prévios de angioedema e quando há alterações significativas da volemia. A literatura é escassa no que que diz respeito à associação de angioedema hereditário e gravidez. Descrevemos um caso de sucesso de uma grávida com angioedema hereditário tipo I submetida a cesariana.
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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We report the case of a pregnant patient diagnosed with Cockayne syndrome, submitted successfully to spinal anesthesia for a cesarean section due to cephalopelvic disproportion. In view of the difficult decision between inducing general anesthesia in a patient with a likely difficult airway, or neuraxial anesthesia in a patient with cardiovascular, respiratory and neurocognitive limitations, we suggest tailored management to reach the best results for the mother and newborn. PMID: 32173062 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Do pregnant women with gestational diabetes mellitus require more opioids during the immediate postoperative period after cesarean section?BMC Anesthesiology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news
ConclusionsThoracic ultrasound is a non-invasive and easy-to-use tool for detecting fluid intolerance in pregnant women undergoing cesarean section. BNP levels were slow to rise following the cesarean section and did not show any clear correlation with fluid volumes administered.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
We report the case of a pregnant patient diagnosed with Cockayne Syndrome, submitted successfully to spinal anesthesia for a cesarean section due to cephalopelvic disproportion. In view of the difficult decision between inducing general anesthesia in a patient with a likely difficult airway, or neuraxial anesthesia in a patient with cardiovascular, respiratory and neurocognitive limitations, we suggest tailored management to reach the best results for the mother and newborn.ResumoA síndrome de Cockayne é doença multissistêmica autossômica recessiva devido à falha no reparo do DNA. Or...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
ConclusionCombined Rendez-vous isthmoplasty is feasible, safe, and effective in experienced hands, giving the surgeon a comprehensive evaluation of the anatomy of the isthmocele, and increasing the odds of a complete resection and restoration of the anatomy 4, 5, 6, 7. In this patient, the procedure was uneventful, without any intra- or postoperative complications, and the symptoms were completely controlled.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
G Arora, N SahniJournal of Postgraduate Medicine 2020 66(1):51-53 Sheehan's syndrome (SS) is caused by infarction of the pituitary gland usually precipitated by hypotension due to massive uterine hemorrhage during the peripartum period. Once SS develops, it becomes a major comorbidity for the young females and predisposes them to further medical, obstetric, and anesthetic complications. Herein, we report the perioperative anesthetic management of a 28-year-old female, already diagnosed with SS precipitated by urosepsis and septicemic shock in a previous pregnancy, now presenting with twin pregnancy for elective cesare...
Source: Journal of Postgraduate Medicine - Category: Internal Medicine Authors: Source Type: research
Publication date: December 2019Source: Chinese Medical Sciences Journal, Volume 34, Issue 4Author(s): Xu Li, Biye Wu, Mingzhu Zhang, Le ShenObjectiveNeuraxial block is the most common anesthesia method for cesarean section (CS). However, for some urgent and high-risk cesarean delivery, general anesthesia (GA) also plays a very important role. We aimed to find out the reasons of choosing GA for CS in our center and the factors that may be related to the maternal and fetal outcomes.MethodsWe retrospectively selected parturients who had CS procedures under GA in Peking Union Medical College Hospital from January 1, 2014 to De...
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research
We present a case of a 44-year-old pregnant female known for DCM with low ejection fraction who underwent an elective cesarean section and tubal ligation. The patient was transferred to the intensive care unit in a stable condition with a favorable outcome. Awareness about the appropriate anesthetic management for this type of patients is of paramount importance because similar cases are likely to be encountered with the advances in modern medicine.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusion: Our observations suggest the possibility of a potential anatomical particularity of the dural canal in this patient and question the safety of performing an epidural catheterization for further procedures.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Rationale: Anesthetic management of pregnant women with Fontan circulation remains challenging. There are few reports that describe the anesthetic management of cesarean section after Fontan surgery. Here, we present a case of successful epidural anesthesia in a woman with Fontan circulation who required emergency cesarean section. Patient concerns: A 29-year-old woman at gestational week 28 was scheduled for emergency cesarean section because of fetal distress. Her past medical history was significant for congenital transposition of the great arteries that had been treated by Fontan surgery 26 years earlier. Her post...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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