ABSTRACT
After an uneventful caesarean delivery under spinal anaesthesia (hyperbaric bupivacaine 10mg, sufentanil 5µg and morphine 50µg), hypothermia (nadir 34°C) was recorded in a ASA 1 patient. Partial recovery was rapidly obtained with 400µg of naloxone but full recovery was obtained after seven hours of active rewarming with a forced-air warming blanket. Suggested pathophysiology and incidence of this hypothermia are described.
Subject(s)
Analgesics, Opioid/adverse effects , Cesarean Section , Hypothermia/chemically induced , Morphine/adverse effects , Adult , Analgesics, Opioid/administration & dosage , Anesthesia, Spinal , Female , Humans , Hypothermia/drug therapy , Infant, Newborn , Injections, Spinal , Morphine/administration & dosage , Naloxone/therapeutic use , Narcotic Antagonists/therapeutic use , Pregnancy , RewarmingABSTRACT
During pregnancy, the plasma concentration of factor VII increases to reach values during the third trimester that can be twice the normal values (N: 70% to 140%). Congenital factor VII deficiency is a rare condition which may lead to haemorrhage. We report the case of a patient with a congenital factor VII deficiency who presented with severe postpartum haemorrhage requiring resuscitation with blood transfusion and surgical haemostasis. We discuss the treatment of congenital factor VII deficiency and its anaesthetic management, as well as the hemorrhagic risk during pregnancy.
