麻酔と蘇生 Volume 53 Issue 3
published_at 2017-09-20

帝王切開を脊髄くも膜下麻酔で2度行った血友病A確定保因者の麻酔管理

Anesthetic Management for Hemophilia A Carrier Who Underwent Caesarean Section Procedures Twice with Subarachnoid Anesthesia
Noda Yuko
Abstract
Hemophilia A carriers are usually asymptomatic and their risk of bleeding when giving birth is not necessarily high, since the level of coagulation factor VIII (FVIII) increases during the perinatal period. However, for mothers whose FVIII activity remains low, bleeding risk is increased and a Caesarean section is required when the fetus is a male. We report here anesthetic management for a hemophilia A carrier who underwent a selective Caesarean section procedure on two separate occasions during birth of male infants. The level of FVIII was noted to be increased during the perinatal period, thus management by spinal subarachnoid anesthesia alone was used for the first childbirth and combined spinal-epidural anesthesia for the second. FVIII remained within a normal range throughout both procedures, and no complications occurred in either the mother or the newborns.
Descriptions
本稿の要旨は第119回日本産科麻酔学会学術集会(2015年,東京)において発表した。
Keywords
血友病A保因者
帝王切開
第Ⅷ因子
区域麻酔
hemophilia A carrier
caesarean section
blood coagulation factor VIII (FVIII)