title: Anaesthesia for caesarean section in a patient with Budd-Chiari syndrome and hepatopulmonary syndrome post liver transplantation.
abstract: Hepatopulmonary syndrome is characterised by hypoxaemia and intrapulmonary shunting in the presence of portal hypertension. It is uncommon in the obstetric population but may occur in patients with Budd-Chiari syndrome in the absence of severe liver dysfunction. We discuss the management of a primigravida with Budd-Chiari syndrome and persistent hepatopulmonary syndrome post liver transplantation. A literature review revealed only one report of a successful pregnancy in association with hepatopulmonary syndrome. We discuss its recognition in patients with liver disease and anaesthetic considerations in its presence.
authors.affiliation: Department of Anaesthetics, Royal Free Hospital, Hampstead, London, UK. tljdoc@aol.com
authors.forename: T L
authors.initials: TL
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: O'Beirne
authors.forename: A
authors.initials: A
authors.lastname: Goode
authors.forename: S
authors.initials: S
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D006502:Budd-Chiari Syndrome / Q000150:complications* / Q000601:surgery; D002585:Cesarean Section; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D016031:Liver Transplantation; D009407:Nerve Block; D011247:Pregnancy; D011248:Pregnancy Complications