RESUMO
A healthy 34-year-old full-term parturient was admitted to the labor suite where a combined spinal-epidural (CSE) was easily placed on the first attempt for labor analgesia. After an uneventful delivery, the epidural catheter was removed. Two days later, the patient experienced a fluid leak from the puncture site. The fluid was analyzed to determine whether it was an interstitial or a cerebrospinal fluid (CSF). We describe a novel technique to collect the leaking fluid without admixing fluid from the surrounding area. No previous reports describe a similar technique to diagnose the source of this questionable fluid leak.
RESUMO
Anesthesia for Cesarean section could be challenging due to the physiological changes during pregnancy, but it can be more complicated if associated with sickle cell disease and moyamoya disease. The moyamoya syndrome is nothing but sickle cell disease complicated by cerebral vasculopathy. Incidence of moyamoya disease in the USA is 0.086/100,000 people. We report a case of a pregnant woman with sickle cell disease and moyamoya syndrome, who underwent a successful spinal epidural for primary cesarean section, with careful monitoring of blood pressure.