Korean J Asthma Allergy Clin Immunol.  2012 Dec;32(4):264-267.

A Case of Cesarean Section Delivery in a Patient with Hereditary Angioedema

Abstract

BACKGROUND
Hereditary angioedema is a rare disease caused by a deficiency of C1 inhibitor and inherited in an autosomal dominant manner. It leads to episodic abdominal pain and angioedema which can be life-threatening. Associations between hereditary angioedema and pregnancy have been reported in the literature. The frequency of symptoms increases during pregnancy and the postpartum period. While complications during vaginal delivery are generally known to be rare in patients with heterditary angioedema, acute attack of heterditary angioedema may occur during Cesarean section. CASE HISTORY: A 34-year-old pregnant woman was admitted for the induction of labor with suspected preeclampsia. The patient was diagnosed with hereditary angioedema 5 years ago and treated with tranexamic acid when needed. During the first trimester of pregnancy, the incidence of attacks increased but she did not take any medication. She had prophylactic tranexamic acid for 2 weeks before delivery. Emergency Cesarean section was performed due to fetal deceleration that occurred during labor induction.
RESULTS
After injection of a C1 inhibitor in the phase of anesthesia induction, delivery was successful without any complications.
CONCLUSION
We report a case of Cesarean section delivery with a prophylactic use of a C1 inhibitor in a patient with hereditary angioedema.

MeSH Terms

Abdominal Pain
Anesthesia
Angioedema
Angioedemas, Hereditary
Cesarean Section
Complement C1 Inhibitor Protein
Deceleration
Emergencies
Female
Humans
Incidence
Postpartum Period
Pre-Eclampsia
Pregnancy
Pregnancy Trimester, First
Pregnant Women
Rare Diseases
Tranexamic Acid
Complement C1 Inhibitor Protein
Tranexamic Acid