Anaesthetic management of splenectomy in Evan's syndrome during pregnancy with pregnancy induced hypertension.
The management of idiopathic thrombocytopenic purpura (ITP) during pregnancy, especially with ongoing bleeding diathesis, has not been highlighted sufficiently in the literature. Aortocaval compression and reduction in uteroplacental circulation resulting in foetal hypoxia and acidosis, Mendelson's syndrome due to gravid uterus, trauma to airway with resultant haemorrhage and aspiration into lungs, compromised airway due to short neck, anasarca and heavy breast, limitation in using invasive monitoring and regional anaesthesia and uncontrolled bleeding leading to placental hypoperfusion and foetal hypoxia are some of the important risks. In the present case report, anaesthetic management for splenectomy during pregnancy complicated with pregnancy induced hypertension and bleeding diathesis secondary to ITP is described with reference to above risks.
Sherke
R R
RR
Department of Anaesthesiology & Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, India. sherkerupali@hotmail.com
Rao
M S
MS
D000328:Adult; D000743:Anemia, Hemolytic / Q000150:complications / Q000628:therapy; D000768:Anesthesia, General / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000628:therapy; D013156:Splenectomy; D013577:Syndrome; D016896:Treatment Outcome