Anaesthetic Management of Pre Eclamptic Patient with Solitary Kidney and Uterine Didelphys Posted for Emergency Caesarean Section: A Case Report

Abstract

Uterine didelphys results from impaired fusion of the paired Müllerian ducts. The incidence of uterine anomalies is believed to be 0.5–2.0% of reproductive-age women, with didelphic uterus renal agenesis accounting for approximately 10%. Uterine didelphys is associated with in approximately 25% of cases1. Pre eclampsia is defined as SBP more than 160 mmhg, DBP more than 90 mmhg, associated with proteinuria and urine protein excretion >300mg in a 24 hour period or a protein creatinine ratio of atleast 0.32. Neuraxialblockade stands an effective mode of anaesthesia for these patients. Management of pre eclampticpatient with solitary kidney can be a challenge to anaesthesiologist due tovarious metabolic derangements including hyperkalemia, hypocalcemia, hyperphosphatemia and metabolic acidosis.Multidisciplinary approach is required to have good pregnancy outcome in these patients.