• K Hara, Y Saito, N Morimoto, S Sakura, and Y Kosaka.
• Department of Anesthesiology, Shimane Medical University, Izumo City, Japan.
• Can J Anaesth. 1998 Feb 1; 45 (2): 157-63.

PurposeThis case report describes the anaesthetic management for Caesarean section in a patient with myelodysplastic syndrome.Clinical FeaturesA woman with myelodysplastic syndrome underwent Caesarean section on two occasions. The first Caesarean section was performed at age 20 yr using general anaesthesia with nitrous oxide-oxygen and fentanyl. In her second pregnancy at 25 yr, there was severe pancytopenia at 28-wk gestation with a leukocyte count 3.6 x 10(9).L-1, erythrocyte count 1.2 x 10(12).L-1, haemoglobin 50 g.L-1, haematocrit 14.7% and platelet count 51 x 10(9).L-1. Following leukocyte poor red cells and platelet transfusion, general anaesthesia was maintained with nitrous oxide-oxygen-sevoflurane and fentanyl. Both operations were uneventful and healthy infants were delivered.ConclusionIt is important to have a team approach (anaesthetist, obstetrician and haematologist) for the perianaesthetic management of patients with myelodysplastic syndrome. An exact assessment of the haematological condition, the need for prophylactic treatment and anaesthetic management should be determined for each individual patient.

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