[Anaesthesia for cesarean section in a patient with acute viral hepatitis (author's transl)].

Acute viral hepatitis is hazardous in the obstetric patient because of associated multi-system involvement which may include coagulation defects. The fetus may be compromised by maternal complications as well as by high levels of indirect bilirubin which crosses the placenta. Cesarean section is frequently indicated for fetal distress or failed progress of labor. An elderly primigravida with severe acute viral hepatitis complicated by gastrointestinal bleeding, hypofibrinogenemia, thrombocytopenia and prolonged prothrombin and partial thromboplastin times required emergency cesarean section. Clotting factors were replenished prior to surgery. General anesthesia with low-dose ketamine induction and high inspired oxygen fraction was considered the method of choice for the specific maternal and fetal problems.