Anesthetic management of a pregnant woman with autoimmune hemolytic anemia for an emergency cesarean section. Report of a patient

Abstract

The case of a young patient who underwent a cesarean section is reported. She showed severe anemia in the perinatal tests, and did not improve with iron therapy with intramuscular Inferon. The patient received a blood transfusion which caused an immediate transfusion reaction with tremors, headache, chills and facial flushing. An inter consultation with the Department of Hematology was carried out and the patient was diagnosed with autoimmune hemolytic anemia with negative Coombs test. She had a spontaneous rupture of the membranes with uterine contractions at 39.2 weeks of gestational age, and had a hemoglobin level of 7.7g/l. The anesthetic management was based on an intentional hypervolemic hemodilution, the selection of endotracheal general anesthesia in rapid sequence, perioperative steroid use, infusion of tranexamic acid and intraoperative blood -saving measures. The maternal-fetal postoperative course was satisfactory and the patient was discharge under steroid treatment 96 hours after the intervention.

Keywords

• anemia hemolítica autoinmune
• anestesia obstétrica
• cesárea