Anesthetic management of a cervicoisthmic pregnancy patient undergoing cesarean section

Megumi Kimura, Yuji Karashima, Makoto Sumie, Norimitsu Sugioka, Youhei Yamada, Yasuyuki Fujita, Tadashi Kandabashi, Sumio Hoka

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Cervicoisthmic pregnancy is a rare obstetric condition that is potentially dangerous for the pregnant woman due to a high risk of abortion or preterm delivery. We here present a 29-year-old woman with cervicoisthmic pregnancy undergoing cesarean section at full term. Under combined epidural and spinal anesthesia, an infant was delivered alive, and the placenta was preserved without any forces to detach from the uterus. The surgery was completed without massive bleeding. The retained placenta was treated with methotrexate infusion into the uterus from the 6th day as well as uterine artery embolization at the 51th day postpartum. She subsequently required manual removal of the retained placenta under combined epidural and spinal anesthesia with only small bleeding. She was discharged from our hospital uneventfully. Meticulous preparation for massive bleeding and long-term treatment of the retained placenta are important in the perioperative management for cesarean section of a full term patient with cervicoisthmic pregnancy.

Original languageEnglish
Pages (from-to)390-392
Number of pages3
JournalJapanese Journal of Anesthesiology
Issue number4
Publication statusPublished - Apr 10 2012

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine


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