General Anesthesia for Cesarean Section of a Parturient with Aplastic Anemia Refractory to Platelet Transfusion

Lee, Han Sook; Lee, Hae Jin

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2007;2(4):242-245.
Published online October 30, 2007.

General Anesthesia for Cesarean Section of a Parturient with Aplastic Anemia Refractory to Platelet Transfusion

Department of Anesthesiology and Pain Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea. lehaji@catholic.ac.kr

Abstract

Aplastic anemia is pancytopenia with bone marrow hypocellularity. The major risks to the pregnant women with aplastic anemia are hemorrhage and infection. Mortality during or after pregnancy is very high, especially thrombocytopenia complicated by platelet refractoriness, due to bleeding and sepsis. There is no therapeutic guideline for aplastic anemia with platelet refractoriness about cesarean section. A multidisciplinary approach to patients with aplastic anemia refractory to platelet transfusion is essential. Close consultation among the hematologist, anesthesiologist and obstetrician, and a management plan are important. We report the successful management of such a patient during cesarean section under general anesthesia.

Key Words: aplastic anemia, cesarean section, general anesthesia, platelet refractoriness, thrombocytopenia