유전성 혈관부종 환자에서의 성공적인 제왕절개 분만 1예
A Case of Cesarean Section Delivery in a Patient with Hereditary Angioedema
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Background: Hereditary angioedema is a rare disease caused by a deficiency of C1 inhibitor and inherited in an autosomal dominant manner. It leads to episodic abdominal pain and angioedema which can be life-threatening. Associations between hereditary angioedema and pregnancy have been reported in the literature. The frequency of symptoms increases during pregnancy and the postpartum period. While complications during vaginal delivery are generally known to be rare in patients with heterditary angioedema, acute attack of heterditary angioedema may occur during Cesarean section. Case History: A 34-year-old pregnant woman was admitted for the induction of labor with suspected preeclampsia. The patient was diagnosed with hereditary angioedema 5 years ago and treated with tranexamic acid when needed. During the first trimester of pregnancy, the incidence of attacks increased but she did not take any medication. She had prophylactic tranexamic acid for 2 weeks before delivery. Emergency Cesarean section was performed due to fetal deceleration that occurred during labor induction. Results: After injection of a C1 inhibitor in the phase of anesthesia induction, delivery was successful without any complications. Conclusion: We report a case of Cesarean section delivery with a prophylactic use of a C1 inhibitor in a patient with hereditary angioedema.
Abstract
Background: Hereditary angioedema is a rare disease caused by a deficiency of C1 inhibitor and inherited in an autosomal dominant manner. It leads to episodic abdominal pain and angioedema which can be life-threatening. Associations between hereditary angioedema and pregnancy have been reported in the literature. The frequency of symptoms increases during pregnancy and the postpartum period. While complications during vaginal delivery are generally known to be rare in patients with heterditary angioedema, acute attack of heterditary angioedema may occur during Cesarean section. Case History: A 34-year-old pregnant woman was admitted for the induction of labor with suspected preeclampsia. The patient was diagnosed with hereditary angioedema 5 years ago and treated with tranexamic acid when needed. During the first trimester of pregnancy, the incidence of attacks increased but she did not take any medication. She had prophylactic tranexamic acid for 2 weeks before delivery. Emergency Cesarean section was performed due to fetal deceleration that occurred during labor induction. Results: After injection of a C1 inhibitor in the phase of anesthesia induction, delivery was successful without any complications. Conclusion: We report a case of Cesarean section delivery with a prophylactic use of a C1 inhibitor in a patient with hereditary angioedema.
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