Anesthetic considerations for cesarean delivery in a parturient with hereditary hemorrhagic telangiectasia: a case report

JA Clinical Reports

Eisuke Kako¹  Kazuya Sobue¹  Toshiyuki Nakanishi¹  Motoshi Tanaka¹  Yuji Kamimura¹  Aiji (Boku)Sato² 

[1] Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan;Department of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, 464-8651, Nagoya, Japan;

关键词: Hereditary hemorrhagic telangiectasia;    Rendu-Osler-Weber syndrome;    Pulmonary arteriovenous malformation;    Cesarean delivery;    Spinal magnetic resonance imaging;   

DOI  :  10.1186/s40981-021-00420-4

来源: Springer

【 摘 要 】

BackgroundHereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant disorder characterized by mucocutaneous telangiectasia and arteriovenous malformations (AVMs). There are some anesthetic considerations for cesarean delivery in a parturient with HHT.Case presentationA 27-year-old parturient with pulmonary hemorrhage was admitted to our tertiary perinatal center. She was first diagnosed with HHT and a cesarean delivery using spinal anesthesia at 37 weeks of gestation was initially planned. However, magnetic resonance imaging (MRI) at 32 weeks of gestation revealed spinal AVM ranging from the thoracic to the lumbar levels. Thus, elective cesarean delivery under general anesthesia was planned. The parturient had an uneventful perioperative course.ConclusionsHHT should be considered as a differential diagnosis when parturients develop pulmonary hemorrhage. In a cesarean delivery of parturients with HHT, spinal MRI during pregnancy can help in deciding the anesthetic procedure to be used.

【 授权许可】

CC BY