Cesarean section by local anesthesia in patients with familial dysautonomia

Article Abstract:

Familial dysautonomia is a genetic disorder that is characterized by abnormalities in the development of the autonomic and sensory nervous systems, resulting in profuse sweating, vomiting and lung infections, as well as other symptoms. It primarily affects members of the Ashkenazi Jewish population. Patients with this disorder are very sensitive to anesthesia. This study examined the case of a 29-year-old Jewish woman with the disorder who required anesthesia prior to undergoing cesarean section. A local anesthetic was given so as to avoid the adverse effects associated with general anesthetics. She was initially seen at 8 weeks' gestation, and her medical history indicated frequent episodes relating to familial dysautonomia. Amniocentesis was performed at 16 weeks' gestation and the fetus appeared normal. Fetal problems began at 34 weeks' gestation and a cesarean was decided upon two weeks later. A local anesthetic of 1 percent lidocaine hydrochloride solution was used. The infant was delivered with little pain to the mother. The local anesthetic was applied until suturing was completed. The infant and the mother encountered no problems. These results indicate that a local anesthetic is effective when a cesarean section is required in a patient suffering from familial dysautonomia, and thus can be used to bypass the possible complications of a general anesthetic. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Complications and side effects, Cesarean section, Dysautonomia, Local anesthesia, General anesthesia

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Detection of adrenomedullin, a hypotensive peptide, in amniotic fluid and fetal membranes

Article Abstract:

Adrenomedullin may prove to play an important role in human pregnancy. Adrenomedullin is a protein that has been shown to play a role in dilating blood vessels, promoting kidney function, dilating lung air sacs, promoting nerve transmission, stimulating growth, and fighting infection. An analysis of amniotic fluid from 134 pregnant women undergoing amniocentesis revealed that adrenomedullin was present and that cells from the amniotic membrane were a probable source. This suggests that adrenomedullin has some function or functions in human pregnancy.

Analysis, Measurement, Physiological aspects, Peptide hormones, Pregnancy, Amniotic fluid

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