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Canadian Journal of Anesthesia, Vol 45, 157-163, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthetic management of caesarean section in a patient with myelodysplastic syndrome

K Hara, Y Saito, N Morimoto, S Sakura and Y Kosaka
Department of Anesthesiology, Shimane Medical University, Izumo City, Japan.

PURPOSE: This case report describes the anaesthetic management for Caesarean section in a patient with myelodysplastic syndrome. CLINICAL FEATURES: A woman with myelodysplastic syndrome underwent Caesarean section on two occasions. The first Caesarean section was performed at age 20 yr using general anaesthesia with nitrous oxide-oxygen and fentanyl. In her second pregnancy at 25 yr, there was severe pancytopenia at 28-wk gestation with a leukocyte count 3.6 x 10(9).L-1, erythrocyte count 1.2 x 10(12).L-1, haemoglobin 50 g.L-1, haematocrit 14.7% and platelet count 51 x 10(9).L-1. Following leukocyte poor red cells and platelet transfusion, general anaesthesia was maintained with nitrous oxide-oxygen-sevoflurane and fentanyl. Both operations were uneventful and healthy infants were delivered. CONCLUSION: It is important to have a team approach (anaesthetist, obstetrician and haematologist) for the perianaesthetic management of patients with myelodysplastic syndrome. An exact assessment of the haematological condition, the need for prophylactic treatment and anaesthetic management should be determined for each individual patient.


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A. Y. C. Wong, R. S. N. Chan, and M. G. Irwin
Anesthetic management of Cesarean delivery in a patient with hypoplastic anemia and severe pre-eclampsia: [L'anesthesie pendant une cesarienne chez une patiente qui presente une anemie hypoplasique et une preeclampsie severe]
Can J Anesth, November 1, 2004; 51(9): 923 - 927.
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Copyright © 1998 by the Canadian Anesthesiologists' Society.