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Anesthetic management of vaginal delivery in a parturient with hemochromatosis induced end-organ failure

Authors
Journal
International Journal of Obstetric Anesthesia
0959-289X
Publisher
Elsevier
Publication Date
Volume
21
Issue
1
Identifiers
DOI: 10.1016/j.ijoa.2011.09.001
Keywords
  • Hemochromatosis
  • Pregnancy
  • Analgesia
  • Epidural
Disciplines
  • Medicine

Abstract

Abstract The vast majority of females affected by hemochromatosis are asymptomatic during childbearing years. We were able to provide effective obstetric anesthesia care to a 35-year-old woman with severe hemochromatosis. She had systolic heart failure with a left ventricular ejection fraction of 15%, severe pulmonary hypertension, mitral insufficiency, a history of ventricular tachycardia, cirrhosis, obstructive sleep apnea, gestational diabetes, and severe scoliosis. A multidisciplinary approach was used to stabilize her heart failure and prepare her for childbirth. An arterial line and epidural analgesic were placed before induction of labor. Vaginal delivery was accomplished with passive decent of the fetus and forceps assistance. We discuss hemochromatosis and its implications for the parturient.

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