Journal of the Bahrain Medical Society

Year 2020, Volume 32, Issue 4, Pages 45-47

https://doi.org/10.26715/jbms.32_2020_4_8

Case Report

An Unplanned Pregnancy with Life-Threatening Paroxysmal Nocturnal Hemoglobinuria: A Case Report

Mohammed Abouelela*, Amir Mostafa, Keith Johnson, Ahmed El Desoky, Aysha Al Rowaiei

Author Affiliation

1Department of Anesthesia, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain.

*Corresponding author:
Dr Mohammed Abouelela, Department of Anesthesia, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain; Email: dr.hussein819@hotmail.com

Received date: February 24, 2020; Accepted date: September 10, 2020; Published date: December 31, 2020


Abstract

A 26-year-old Bahraini female with a past medical history significant for diabetes type 2 on metformin and paroxysmal nocturnal hemoglobinuria. An allogenic stem bone marrow transplantation was done from full match siblings approximately one year ago. The patient presented to the labor and delivery ward for possible normal vaginal delivery at 39 weeks gestational age. After hematology review the patient was taken to caesarian section due to failure of progress and the surgery was done successfully under neuraxial anesthesia (epidural top-up). The case illustrates the effectiveness of neuraxial anesthesia in such patient with such rare disease with possible coagulopathy.

Keywords: Bone marrow disorders; Epidural; Neuraxial anesthesia; Paroxysmal nocturnal hemoglobinuria; Unplanned pregnancy