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Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

Authors Zencirci B

Published 27 May 2010 Volume 2010:3 Pages 153—156


Review by Single-blind

Peer reviewer comments 3

Beyazit Zencirci
Kahramanmaras, Turkey

Background: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.

Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.

Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.

Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

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