title: Medical termination of pregnancy in acute intermittent porphyria.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
authors.forename: Meenakshi T
authors.initials: MT
authors.lastname: Sahu
authors.forename: Shalini
authors.initials: S
authors.lastname: Rajaram
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Saxena
authors.forename: Neerja
authors.initials: N
authors.lastname: Goel
authors.forename: Surveen
authors.initials: S
authors.lastname: Ghumman
mesh_terms: 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
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol