General anesthesia for cesarean delivery in a patient with paroxysmal nocturnal hemoglobinuria and thrombocytopenia.
Pregnancy in patients with paroxysmal nocturnal hemoglobinuria (PNH) increases the risk of complement activation, hemolysis, and thrombosis. We describe the anesthetic management of a patient with PNH who underwent general anesthesia for cesarean delivery. Steroids, heparin, and blood products were administered early to minimize the likelihood of a hematologic emergency.


CONCLUSIONS
Pregnancy in patients with paroxysmal nocturnal hemoglobinuria increases the risk of hemolysis, thrombosis, anemia, and thrombocytopenia. We describe the anesthetic management of a patient with paroxysmal nocturnal hemoglobinuria and thrombocytopenia who underwent general anesthesia for cesarean delivery.
Kjaer
Klaus
K
Department of Anesthesiology, Weill Medical College of Cornell University, New York, New York 10021, USA. kkjaer@hotmail.com
Comerford
Michele
M
Gadalla
Farida
F
D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D013921:Thrombocytopenia / Q000150:complications* / Q000517:prevention & control