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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Anaesthesia in a parturient with systemic mastocytosis
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Vol. 69. Issue 6.
Pages 368-371 (June - July 2022)
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Vol. 69. Issue 6.
Pages 368-371 (June - July 2022)
Case report
Anaesthesia in a parturient with systemic mastocytosis
Consideraciones anestésicas en una parturienta con mastocitosis sistémica
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A.L. Fernandes
Corresponding author
luisafernandes90@gmail.com

Corresponding author.
, M. Mendonça, D. Costa, S.C. Freitas, S.M. Pereira
Hospital Central do Funchal, Department of Anesthesiology, Madeira, Portugal
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Abstract

Mastocytosis is characterized by clonal expansion of mast cells, with abnormal accumulation in different organs. Perioperatively, numerous stimuli may lead to the release of vasoactive substances by mast cells. Parturients with systemic mastocytosis pose a challenge to the anesthesiologist: on one hand, the pain and stress of labor may lead to greater mast cell activation and, on the other, the administration of drugs that may possibly trigger the release of mast cell mediators. The authors describe a case of a 34-year-old pregnant woman with systemic mastocytosis who requests labor analgesia. An epidural analgesia was performed after induction of labor, after considering anesthetic particularities. The epidural procedure, labor and delivery were uneventful. A review of systemic mastocytosis is provided and its anesthetic considerations are discussed.

Keywords:
Obstetrical anesthesia
Systemic mastocytosis
Labor
Parturition
Allergy during pregnancy
Mast cells
Resumen

La mastocitosis se caracteriza por la expansión clónica de mastocitos, con acumulación anormal en diferentes órganos. Perioperatoriamente, numerosos estímulos pueden originar la liberación de sustancias vasoactivas por parte de los mastocitos. Las parturientas con mastocitosis sistémica plantean una dificultad al anestesiólogo: por un lado, el dolor y el estrés del parto pueden causar una mayor activación de los mastocitos y, por otro, la administración de fármacos puede desencadenar posiblemente la liberación de mediadores de los mastocitos. Los autores describen un caso de una embarazada de 34 años de edad con mastocitosis sistémica que solicita analgesia para el parto. Se realizó analgesia epidural tras la inducción del parto, una vez consideradas las particularidades anestésicas. El procedimiento epidural, el parto y la expulsión transcurrieron sin incidentes. Se aporta una revisión de la mastocitosis sistémica, y se abordan sus consideraciones anestésicas.

Palabras clave:
Anestesia obstétrica
Mastocitosis sistémica
Esfuerzo
Parto
Alergia durante el embarazo
Mastocitos

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