Abstract

Pregnancy with methemoglobinemia (metHb) poses several challenges to the anaesthesiologist. MetHb is characterized by iron moiety of Hb in the ferric ( Fe 3+) state. MetHb has decreased oxygen carrying capacity and increased oxygen affinity resulting in cyanosis and tissue hypoxia. Clinical features are proportional to the concentration of the MetHb, which range from asymptomatic state to seizures and cardiac arrthymia to fatality. We present a case of primigravida with Methemoglobinemia posted for emergency cesarean section.At presentation she had cyanosis, dyspnoea and pain in abdomen. Her methemoglobin levels were 25%. She was treated with Methylene blue before induction. This article addresses the anaesthetic challenges and precautions to be taken for a successful anaesthetic management of a patient with methemoglobinemia.

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