Anesthetic considerations for cesarean delivery in a parturient with hereditary hemorrhagic telangiectasia: a case report

Abstract Background Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant disorder characterized by mucocutaneous telangiectasia and arteriovenous malformations (AVMs). There are some anesthetic considerations for cesarean delivery in a p...

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Bibliographic Details
Main Authors: Yuji Kamimura, Toshiyuki Nakanishi, Aiji (Boku)Sato, Eisuke Kako, Motoshi Tanaka, Kazuya Sobue
Format: Article
Language:English
Published: SpringerOpen 2021-03-01
Series:JA Clinical Reports
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Online Access:https://doi.org/10.1186/s40981-021-00420-4
Description
Summary:Abstract Background Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant disorder characterized by mucocutaneous telangiectasia and arteriovenous malformations (AVMs). There are some anesthetic considerations for cesarean delivery in a parturient with HHT. Case presentation A 27-year-old parturient with pulmonary hemorrhage was admitted to our tertiary perinatal center. She was first diagnosed with HHT and a cesarean delivery using spinal anesthesia at 37 weeks of gestation was initially planned. However, magnetic resonance imaging (MRI) at 32 weeks of gestation revealed spinal AVM ranging from the thoracic to the lumbar levels. Thus, elective cesarean delivery under general anesthesia was planned. The parturient had an uneventful perioperative course. Conclusions HHT should be considered as a differential diagnosis when parturients develop pulmonary hemorrhage. In a cesarean delivery of parturients with HHT, spinal MRI during pregnancy can help in deciding the anesthetic procedure to be used.
ISSN:2363-9024