Bandarupalli Tanmai, Zbeidy Reine
Medicine, University of Central Florida College of Medicine, Orlando, USA.
Anesthesiology and Perioperative Medicine, University of Miami, Miami, USA.
Cureus. 2025 Jul 23;17(7):e88621. doi: 10.7759/cureus.88621. eCollection 2025 Jul.
In a nonendemic setting, the confluence of malaria and pregnancy presents unique anesthetic challenges, particularly when the infection is undiagnosed at the time of an urgent cesarean section. This report involves a woman in her early 30s at 39 weeks of gestation with no prior health issues, who developed malarial symptoms upon returning from Haiti five months before. During labor, severe fetal heart rate decelerations necessitated immediate surgical intervention. Given the patient's febrile state, rapid induction with etomidate and succinylcholine was selected to minimize hemodynamic instability and secure the airway swiftly. Intraoperatively, close monitoring guided the systemic effects of malaria, such as hypotension and coagulation anomalies. Following delivery, empirical antimalarial treatment was initiated before the confirmatory diagnosis, considering the etiology endemic to the patient's travel history. This case emphasizes the role of flexible, anticipatory anesthetic strategies in urgent obstetric procedures, specifically those involving complex infectious conditions.
在非疟疾流行地区，疟疾与妊娠并存带来了独特的麻醉挑战，尤其是在紧急剖宫产时感染未被诊断出来的情况下。本报告涉及一名30岁出头、妊娠39周的女性，她之前没有健康问题，在五个月前从海地返回后出现了疟疾症状。分娩期间，严重的胎儿心率减速需要立即进行手术干预。鉴于患者的发热状态，选择依托咪酯和琥珀酰胆碱进行快速诱导，以尽量减少血流动力学不稳定并迅速确保气道安全。术中，密切监测指导了疟疾的全身影响，如低血压和凝血异常。分娩后，在确诊之前就开始了经验性抗疟治疗，考虑到患者旅行史中的地方病病因。本病例强调了灵活、前瞻性麻醉策略在紧急产科手术中的作用，特别是那些涉及复杂感染情况的手术。
