Departments of Anesthesiology and Perioperative Medicine.
Medicine, Division of Allergic Diseases.
Pain Med. 2021 Aug 6;22(8):1878-1882. doi: 10.1093/pm/pnaa457.
Hereditary angioedema (HAE) is a disease manifested by repeated episodes of localized submucosal or subcutaneous edematous episodes, potentially triggered by emotional stress, mechanical trauma, or intake of estrogens. We present our experience managing two parturients with HAE. Multidisciplinary care is essential for planning and executing the specialized care of these patients, and management included extensive planning among obstetric, anesthesiology, and allergy and immunology teams. Pregnancy has been shown to have a variable effect on triggering HAE episodes. First-line treatment includes C1 esterase inhibitor concentrate, which can also be used for prophylaxis in high-risk patients. Neuraxial analgesia is recommended to avoid general anesthesia and was established early in both individuals. Vaginal delivery was well tolerated without need for emergent treatment for angioedema symptoms.
遗传性血管性水肿（HAE）是一种以反复出现局部黏膜下或皮下水肿为特征的疾病，可能由情绪压力、机械创伤或摄入雌激素引发。我们介绍了管理两名 HAE 产妇的经验。多学科护理对于规划和执行这些患者的专业护理至关重要，管理包括产科、麻醉科、过敏和免疫学团队之间的广泛规划。妊娠对引发 HAE 发作的影响是多变的。一线治疗包括 C1 酯酶抑制剂浓缩物，也可用于高危患者的预防。建议使用椎管内镇痛以避免全身麻醉，并且在这两个人中都很早就建立了这种方法。阴道分娩耐受良好，无需紧急治疗血管性水肿症状。
