Anesthesia for Cesarean Delivery in a Pregnant Woman with Acute Hepatic Failure

Abstract

A case of reactivation of hepatitis B and development of fulminant hepatic failure in a pregnant hepatitis B virus carrier is reported. Although the occurrence or reactivation of hepatitis B in pregnancy are rare and usually not considered to be medical indications for termination of pregnancy, decisions regarding delivery and liver transplantation must be made if severe hepatic failure develops.

Hepatic failure in pregnancy successfully treated by online hemodiafiltration: Chronic hepatitis B virus infection without viral genome mutation

“…According to Li et al ., fulminant hepatitis in pregnancy occurs most frequently during late pregnancy and tends to have more severe complications than fulminant hepatitis not developing in pregnancy. Considering prior case reports of hepatic failure in pregnancy, careful monitoring for viral replication in pregnant HBV carriers is important for the prevention of hepatitis exacerbation and for improving perinatal outcomes.…”

“…ALTHOUGH POST‐PARTUM EXACERBATION of hepatitis B in hepatitis B e‐antigen (HBeAg) positive carrier mothers has been recognized, there are few reports documenting hepatic failures triggered by acute exacerbation of hepatitis B virus (HBV) infection in pregnancy, and none of the reports present the genome sequence of HBV in these cases. Herein, we report the clinical efficacy of artificial liver support (ALS) in a case with progression of chronic HBV infection to hepatic failure in late pregnancy.…”

Maternal and perinatal outcome in cases of fulminant viral hepatitis in late pregnancy

“…Furthermore, prolonged vaginal delivery can aggravate the condition by consuming more energy and causing pain. Therefore, with improvements in anesthetic techniques, cesarean delivery has been advocated by some researchers for patients with FVHILP who have not entered labor but who are in need of delivery [11,20]. In previous studies [1,10] based on 1-way analysis of variance in the prognosis of FVHILP, it was found that Tch, PTA, Scr, WBC, and the presence of 3 or more intractable complications were important factors influencing patient prognosis.…”

Pregnant woman with fulminant hepatic failure caused by hepatitis B virus infection: A case report

“…But sedatives such as luminal were not taken into consideration. General anesthesia instead of epidural anesthesia was to avoid epidural hematoma [16] , and during cesarean section [17] , we chose longitudinal incision. After cesarean section, we performed hysterectomy and placed an absorbable hemostatic gauze on the cervical stump to reduce hemorrhage during and after operation.…”