Anaesthetic management of caesarean section in a patient with active recurrent genital herpes and AIDS-related dementia

We report the anaesthetic management of a pregnant patient with multiple manifestations of HIV infection who underwent Caesarean section. A 30-yr-old, HIV-positive, Haitian woman presented with acute psychosis at 28 weeks' gestation. A diagnosis of HIV dementia complex was made and haloperidol...

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Bibliographic Details
Published in:British Journal of Anaesthesia 1995-11, Vol.75 (5), p.639-641
Main Authors: Birnbach, D J, Bourlier, R A, Choi, R, Thys, D M
Format: Article
Language:English
Subjects:
Abdominal surgery. Urology. Gynecology. Obstetrics
Adult
AIDS Dementia Complex
AIDS/HIV
Anesthesia
Anesthesia depending on type of surgery
Anesthesia, Obstetrical - methods
Anesthesia, Spinal
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cesarean Section
Female
Herpes Genitalis
Humans
Medical sciences
Pregnancy
Pregnancy Complications, Infectious
Recurrence
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Summary:We report the anaesthetic management of a pregnant patient with multiple manifestations of HIV infection who underwent Caesarean section. A 30-yr-old, HIV-positive, Haitian woman presented with acute psychosis at 28 weeks' gestation. A diagnosis of HIV dementia complex was made and haloperidol therapy was started. Five days after admission the patient was found to be in labour and tocolytic therapy with terbutaline was commenced. A vaginal lesion compatible with herpes simplex virus was observed which was treated with acyclovir. After 3 days of tocolytic therapy there were no further signs of preterm labour. Two weeks later, at 30 weeks' gestation, the patient's membranes ruptured spontaneously. The herpes labialis lesion was still present and urgent Caesarean section was begun using subarachnoid 0.75% bupivacaine 1.5 ml. The patient had no intraoperative problems and a 1700-g healthy male child was delivered.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/75.5.639