Author(s)

Carlos Vera-Aguilera^1,3, Jose M. Torres-Zazueta¹, Jena Konkler², Jesus Vera-Aguilera^2*, Sergio Ariel Soto-Hopkins^1,3

¹Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico.
²Department of Hematology and Oncology, Essentia Health, Duluth, Minnesota, USA.
³Departamento de Anestesiologis, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexico.

Background: Management of immune thrombocytopenia (ITP) during pre- gnancy can be challenging, particularly by identifying a threshold for safe administration of neuraxial/general anesthesia and minimizing postpartum hemorrhage. There is controversy over the safety of cesarean section (CS) in ITP patients. In this case report, we discuss general anesthesia management in a patient with ITP with severe thrombocytopenia. Case Presentation: A 28-year-old female with relapsed/refractory ITP and severe thrombocytopenia underwent general anesthesia and emergent cesarean section with successful outcomes and minimal bleeding. Platelet counts before CS were 5000 × 10⁹ L, the patient received 1 unit of platelets before the procedure and 1 unit of platelet and tranexamic acid 500 mg was injected slowly during the procedure. No evidence of bleeding and no complications were observed in the patient or newborn. Conclusions: In an emergent circumstance, general anesthesia and cesarean section procedure were performed safely in a patient with severe thrombocytopenia, no hemorrhagic complications were seen for this patient or neonate. Objective of This Manuscript: To share our experience of a safe emergent CS procedure and general anesthesia in a patient with severe thrombocytopenia. Our experience may guide the management of ITP patients in emergent delivery circumstances.

Immune Thrombocytopenia, Pregnancy, Cesarean Section, General Anesthesia, Bleeding

Vera-Aguilera, C. , Torres-Zazueta, J. , Konkler, J. , Vera-Aguilera, J. and Soto-Hopkins, S. (2022) General Anesthesia for Cesarean Section in a Pregnant Woman with Immune Thrombocytopenic Purpura (ITP): A Case Report and Review of the Literature. Open Journal of Anesthesiology, 12, 49-54. doi: 10.4236/ojanes.2022.121005.