From the John Sealy School of Medicine, Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas.
Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas.
A A Pract. 2024 Sep 9;18(9):e01833. doi: 10.1213/XAA.0000000000001833. eCollection 2024 Sep 1.
Hereditary angioedema (HAE) is a rare disorder due to C1 esterase inhibitor deficiency, causing recurrent swelling. Pregnancy can exacerbate HAE due to estrogen fluctuations alongside peripartum stress and trauma. We present a pregnant patient with HAE who underwent induction of labor and vaginal delivery with neuraxial anesthesia. Management included C1-inhibitor prophylaxis, 48 hours of postpartum monitoring, and a self-treatment plan at discharge. Angioedema prevention involves timely anesthesia consultation, accessible emergency airway equipment, early neuraxial anesthesia, planned vaginal delivery, and 48 to 72 hours of close postpartum monitoring. Readily available C1-inhibitor and a multidisciplinary approach with these recommendations are crucial for peripartum management.
遗传性血管性水肿（HAE）是一种罕见的疾病，由于 C1 酯酶抑制剂缺乏导致反复发作的肿胀。由于雌激素波动、围产期应激和创伤，妊娠可使 HAE 加重。我们介绍了一位患有 HAE 的孕妇，她接受了椎管内麻醉诱导分娩和阴道分娩。管理包括 C1 抑制剂预防、产后 48 小时监测和出院时的自我治疗计划。血管性水肿的预防包括及时的麻醉咨询、可及的紧急气道设备、早期的椎管内麻醉、计划的阴道分娩和产后 48 至 72 小时的密切监测。随时可用的 C1 抑制剂和多学科方法及其建议对于围产期管理至关重要。
