Perioperative anesthetic management for cesarean delivery of severe Wilson’s disease with liver failure: a case report

Background Wilson’s disease is a rare autosomal recessive disorder affecting copper metabolism, which presents liver and brain dysfunction caused by abnormal copper accumulation. We report a patient who showed exacerbation of liver failure during pregnancy. Case presentation A 24-year-old woman with...

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Bibliographic Details
Published in:JA clinical reports 2019-11, Vol.5 (1), p.75-75, Article 75
Main Authors: Saito, Kana, Onishi, Eiko, Itagaki, Jun, Toda, Noriko, Haitani, Azusa, Yamauchi, Masanori
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Blood platelets
Case Report
Case reports
Cesarean delivery
Coagulopathy
Critical Care Medicine
Disease
Dyspnea
Edema
Emergency Medicine
Health risk assessment
Hemorrhage
Hepatology
Intensive
Intubation
Liver
Medicine
Medicine & Public Health
Obstetrics
Pain Medicine
Patients
Pregnancy
Rotational thromboelastometry
Wilson’s disease
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Summary:Background Wilson’s disease is a rare autosomal recessive disorder affecting copper metabolism, which presents liver and brain dysfunction caused by abnormal copper accumulation. We report a patient who showed exacerbation of liver failure during pregnancy. Case presentation A 24-year-old woman with Wilson’s disease was scheduled for emergency cesarean delivery at 30 weeks of gestation. The patient exhibited severe coagulopathy and prominent body weight gain (+ 30 kg) caused by systemic edema and ascites. We decided to perform emergency cesarean delivery under general anesthesia. We used platelet concentrates, cryoprecipitate, and fibrinogen concentrate. Intraoperative hemorrhage was well controlled. On the 15th postpartum day, weight was reduced by 20 kg and liver function had improved. She and her baby were discharged without complications. Conclusions The appropriate continued treatment of Wilson’s disease and supplementation of coagulation factors and/or platelets when indicated greatly increase the likelihood of a successful pregnancy, even in patients with liver failure exacerbation.
ISSN:2363-9024
2363-9024
DOI:10.1186/s40981-019-0294-2