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Unexpected chronic methemoglobinemia diagnosis in a pregnant patient in labor

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Resumo:Abstract Methemoglobinemia is a rare hemoglobinopathy which can complicate pregnancy. The obstetric and anesthetic management of methemoglobin pregnant patients is poorly described. We report a case of a 24-year-old patient admitted in labor, with noticeable cyanosis but no respiratory distress. Oxygen saturation was 86%, remaining unaltered after oxygen therapy. Arterial blood gas showed normoxemia and 24,4% methemoglobin. Efforts were directed at limiting the physiologic stress and oxygen consumption, initiating epidural labor analgesia, and performing a vacuum-assisted vaginal delivery. Mo-ther and baby were discharged after an uneventful hospital stay. The etiologic investigation of cyanosis in this patient revealed this rare hemoglobinopathy.
Autores principais:Branco,Rute Isabel
Outros Autores:Santos,Nelson; Ferreira,Ana Paula
Assunto:Cyanosis Methemoglobinemia Pregnancy
Ano:2022
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
Descrição
Resumo:Abstract Methemoglobinemia is a rare hemoglobinopathy which can complicate pregnancy. The obstetric and anesthetic management of methemoglobin pregnant patients is poorly described. We report a case of a 24-year-old patient admitted in labor, with noticeable cyanosis but no respiratory distress. Oxygen saturation was 86%, remaining unaltered after oxygen therapy. Arterial blood gas showed normoxemia and 24,4% methemoglobin. Efforts were directed at limiting the physiologic stress and oxygen consumption, initiating epidural labor analgesia, and performing a vacuum-assisted vaginal delivery. Mo-ther and baby were discharged after an uneventful hospital stay. The etiologic investigation of cyanosis in this patient revealed this rare hemoglobinopathy.