Management of cesarean delivery in a parturient with sickle cell disease. (February 2020)

• Record Type: Journal Article
• Authors: Romano, D.; Craig, H.; Katz, D.
• Is Part Of: International journal of obstetric anesthesia. Volume 41(2020)
• Page Start: 104
• Page End: 107
• Publication Date: 2020-02
• Subjects: Sickle cell anemia -- Cell salvage -- Cesarean delivery -- Hyperhemolysis syndrome -- Pregnancy; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2019.09.001
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: The management of obstetric patients with sickle cell disease (SCD) is complicated. We present an anticoagulated parturient with SCD, antibodies and hyperhemolysis. Using a multidisciplinary approach, emergent cesarean delivery was without incident. Complex management decisions were aided by real-time point-of-care technologies. Abstract: Chronic hemolysis and intermittent vaso-occlusion in sickle cell disease can lead to recurrent blood transfusions with related complications such as antibody formation and rarely, life-threatening reactions. We report a case of a parturient who presented with complications of sickle cell disease and who later had fetal compromise that required an emergent cesarean delivery. Complex management decisions were made, aided by technologies such as rotational thromboelastometry, quantitative blood loss analysis and cell salvage.