title: Scleroderma and pulmonary hypertension complicating two pregnancies: use of neuraxial anesthesia, general anesthesia, epoprostenol and a multidisciplinary approach for cesarean delivery.
abstract: Literature regarding the anesthetic care of patients with scleroderma during labor and delivery is limited to remote case reports. No recent publications provide information on the anesthetic management of patients with coexisting pulmonary hypertension. This report describes the anesthetic and multidisciplinary management of two pregnant patients with concomitant scleroderma and pulmonary hypertension undergoing cesarean delivery; one with neuraxial anesthesia and one with general anesthesia. Considerations for neuraxial and general anesthesia in patients with concurrent scleroderma and pulmonary hypertension are discussed.
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA. Electronic address: dmoaveni@med.miami.edu.
authors.forename: D
authors.initials: D
authors.lastname: Moaveni
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cohn
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Brodt
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Hoctor
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Ranasinghe
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002045:Bupivacaine; D002585:Cesarean Section; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D005283:Fentanyl; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000188:drug therapy; D008738:Methyl Ethers; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012595:Scleroderma, Systemic / Q000150:complications*; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000959:Antihypertensive Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D011464:Epoprostenol; D005283:Fentanyl; D002045:Bupivacaine
keywords: Anesthesia; CREST syndrome; Cesarean delivery; Epoprostenol; Obstetric; Pulmonary hypertension; Scleroderma