Document Detail


Anaesthesia for caesarean delivery in a parturient following a recent cerebrovascular event.
MedLine Citation:
PMID:  18993055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ischaemic cerebrovascular events in pregnancy are uncommon. The anaesthetic management of a pregnant patient within six weeks of an ischaemic cerebrovascular event has not previously been reported. Issues raised include consent and minimising further neurological insult. Changes in regional blood flow, cerebral metabolic rate and integrity of the blood brain barrier must be considered although evidence to support regional in preference to general anaesthesia is lacking. We report the case of a woman with known systemic lupus erythematosis and antiphospholipid syndrome who developed idiopathic thrombocytopenic purpura in pregnancy and suffered a thrombotic cerebral vascular accident at 32 weeks of gestation. Ten days later she required urgent caesarean delivery, which was performed under general anaesthesia. There was no deterioration in neurological function following surgery and eight days postoperatively she was transferred to a neuro-rehabilitation centre for further care. The idiopathic thrombocytopenic purpura did not respond to medical therapy following delivery and a second anaesthetic was required for splenectomy four weeks later.
Authors:
R K Iqbal; R Russell
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-11-06
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  18     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-29     Completed Date:  2009-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  55-9     Citation Subset:  IM    
Affiliation:
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General / methods*
Anesthesia, Obstetrical / methods*
Antiphospholipid Syndrome / complications
Cesarean Section*
Female
Humans
Lupus Erythematosus, Systemic / complications
Pregnancy
Pregnancy Complications, Cardiovascular
Pregnancy Complications, Hematologic
Purpura, Thrombocytopenic, Idiopathic* / complications,  surgery
Stroke* / drug therapy,  etiology
Thrombelastography
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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