Medical termination of pregnancy in acute intermittent porphyria.
Acute intermittent porphyria is a rare autosomal dominant disease characterized by acute attacks of neuropsychiatric and neurovisceral dysfunction. In pregnancy, exacerbation of attacks in the form of seizures and acute abdomen occur due to hormonal changes. We report the case of a young woman presenting at 8 weeks of gestation requesting pregnancy termination. The patient suffered several episodes of acute abdomen and seizures in a prior pregnancy before the diagnosis was clinched. This case is reported because of its rarity and the limited obstetric experience of this disorder. Proper management depends on avoidance of precipitating factors. Anaesthetic drug safety in porphyria is reviewed and the choice of regional anaesthesia discussed.
Sahu
Meenakshi T
MT
Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Rajaram
Shalini
S
Saxena
Ashok Kumar
AK
Goel
Neerja
N
Ghumman
Surveen
S
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D017118:Porphyria, Acute Intermittent / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011261:Pregnancy Trimester, First
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol