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Irish Child Health Database - Peer Reviewed Papers

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  • Autoimmune progesterone dermatitis in a parturient for emergency caesarean section

    Published in:

    Int J Obstet Anesth, Vol: 13, Page: 275-8

    Publication Date:

    October 2004

    Aims & Objectives:

    This case report discusses a case of autoimmune progesterone dermatitis in a parturient who required emergency caesarean section

    Abstract:

    A parturient with a 14-year history of autoimmune progesterone dermatitis presented in labour at 36 weeks' gestation. She had suffered recurrent episodes of angioedema over a long period and had been scheduled for elective caesarean hysterectomy and bilateral oophorectomy at 37 weeks' gestation. In most cases surgical oophorectomy provides prolonged relief from the recurrent angioedema and dermatological manifestations that are typical of autoimmune progesterone dermatitis. Spinal anaesthesia was chosen in order to avoid airway manipulation, a factor frequently implicated in the development of angioedema. Delivery was uneventful and the obstetricians proceeded to hysterectomy and oophorectomy. Forty minutes after delivery the patient experienced an attack of angioedema, she was markedly hypotensive and was given fluids, ephedrine and phenylephrine with good effect. As she remained normotensive, she was given intramuscular rather than intravenous epinephrine to provide a slower release. She recovered well and stabilised without the need for intubation or ventilation. This case reinforces the rationale for regional anaesthesia in these patients and demonstrates how intramuscular epinephrine contributed towards a positive outcome.

    Authors:

    J. O'Rourke; N. Khawaja; J. Loughrey; P. McKenna

    Study Type:

    Study Papers » Case Report Study » Descriptive Studies - Without a comparision

    Categories:

    autoimmune progesterone dermatitis

    International Classification:

    Diseases of the skin and subcutaneous tissue - Report

    Keywords:


    Geography:

    Republic of Ireland (Republic of Ireland)