A & A case reports
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Hypoglycemia is a frequent problem encountered with diabetics and hospitalized patients. Although point-of-care glucose meters have revolutionized management, there are circumstances wherein glucose meter readings are inaccurate. ⋯ After surgery, the patient's laboratory testing reflected hypoglycemia, while point-of-care glucose meter testing indicated hyperglycemia. It is important to remember that the "gold standard" is the laboratory serum glucose test, and if a discrepancy from point-of-care results occurs, an investigation should be made to ascertain the reason.
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Inherited Factor V deficiency is a rare bleeding disorder. We describe the genetic analysis and anesthetic management of a parturient with severe Factor V deficiency who presented in spontaneous labor. Good hemostatic conditions were obtained with prophylactic fresh frozen plasma administration of 10 mL/kg. Detailed genetic analysis by next-generation sequencing identified several relevant mutations in the coding part of the Factor V (F5) gene in our patient, her parents, and the newborn.
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Uterine dehiscence is a known but uncommon complication during pregnancy. The symptoms of uterine dehiscence can be subclinical and usually occur during prolonged augmented labor in women who had previous cesarean delivery and/or are carrying a macrosomic baby. ⋯ However, to our knowledge, spontaneous uterine dehiscence during performance of spinal anesthesia for an elective cesarean delivery has not been reported in obstetric anesthesia practice. Here, we report a case of uterine dehiscence while subarachnoid block was being performed.
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We present the case of a 25-year-old woman with acute fatty liver of pregnancy, a rare mitochondrial disorder that manifests during pregnancy and has a significant mortality rate. Postoperative pain management is challenging for myriad reasons. With the increasing application of transversus abdominis plane blocks for postcesarean delivery analgesia, we describe the real and potential complications of this method of regional analgesia in patients with this disease.