title: [Anesthetic management of emergency cesarean section in a patient with acquired von Willebrand syndrome].
abstract: Acquired von Willebrand syndrome (AvWS) is generic name of bleeding disorders caused by acquired decrease of von Willebrand factor. A 25-year-old woman with AvWS underwent emergent cesarean section under combined spinal and epidural anesthesia. Before operation, her APTT was within normal ranges. Platelet count was about 80,000 and factor VIII and von Willebrand factor's activities were 37% and 21%, respectively. Therefore, we administered 10 units of platelet concentrate and 2,000 units of factor VIII concentrate intravenously before the operation. The emergent operation was done without any bleeding complications. Factor VIII concentrate was administered until 11 days after the operation. Epidural catheter was removed just after administration of factor VIII concentrate 3 days after operation. The perioperative course was uneventful and the patient was discharged 11 days after the operation. It is important to co-operate with other related departments in managing the perioperative coagulation status in a patient with AvWS.
authors.affiliation: Department of Anesthesiology, University of Occupational and Environmental Health, Kitakyushu 807-8555.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Komada
authors.affiliation: Department of Anesthesiology, University of Occupational and Environmental Health, Kitakyushu 807-8555.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: Department of Anesthesiology, University of Occupational and Environmental Health, Kitakyushu 807-8555.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Sata
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section; D003029:Coagulants / Q000008:administration & dosage; D004630:Emergencies; D005169:Factor VIII / Q000008:administration & dosage; D005260:Female; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D017713:Platelet Transfusion; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D014842:von Willebrand Diseases / Q000628:therapy
chemical_list: D003029:Coagulants; D005169:Factor VIII