Abstract
A case is reported of a 28 year old woman, with untreated mitral valve disease and a professional allergy to ethylene oxide and phthalic anhydride, who presented with acute hydramnios during the 35th week of pregnancy. Emergency caesarean section having been decided on, a urinary catheter — sterilized by gamma rays and not ethylene oxide — was inserted ; the gloves used had however been sterilized in ethylene oxide gas, and the patient rapidly presented with anaphylactic shock. The needles and intravenous infusion equipment used were all either sterilized in gamma rays or rinsed in large quantities of liquid. It was decided to abandon the caesarean section and attempt a vaginal delivery using morphine spinal analgesia ; epidural analgesia was absolutely contraindicated because the catheters were sterilized in ethylene oxide and the patient's haemodynamic state was too precarious. Caudal anaesthesia with 0.25 % bupivacaine was used to complete the spinal analgesia and speed up cervical dilatation. The child was delivered with forceps and the diagnosis of oesophageal atresia was confirmed.
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