Combined general-epidural anesthesia for cesarean section in acute fatty liver of pregnancy under monitoring bispectral index: A case report

ABSTRACT

Acute fatty liver of pregnancy is a rare but usually fatal complication of the third trimester. We report the case of a 28-year-old primigravida at 37 weeks of gestation with an acute fatty liver. Continuous fetal heart rate monitoring demonstrated frequent late fetal heart decelerations and the lack of beat-to-beat variability during the induction of vaginal delivery. We decided to perform an emergency cesarean section under a combined general-epidural anesthesia with bispectral index. No complications occurred during or after surgery except for a delayed recovery from the muscle relaxant. The patient made an uneventful recovery and discharged at eight days after cesarean section.