RESUMO
Factor V Leiden mutation is the most common congenital thrombophilic disorder, affecting between 5% and 8% of the Caucasian population. Pregnancy creates a state of hypercoagulability and all factors that increase the risk of thrombosis should be considered, as they may be cumulative. In recent years, the diagnosis of new allelic variants of thrombophilic states have increased the incidence of pregnant women receiving anticoagulant therapy, with the anesthetic considerations that implies. We report the case of a 33-year-old woman with heterozygous Leiden factor V mutation who was admitted with spontaneous amniorrhexis in the 38th week of gestation. She was taking low molecular weight heparin therapy. An epidural catheter was inserted to provide analgesia for labor, with all safety precautions to prevent an epidural hematoma. Epidural anesthesia is the technique of choice for obstetric labor in patients with hypercoagulability because of its effects of favoring blood flow and inhibiting clot formation.
Assuntos
Resistência à Proteína C Ativada/genética , Analgesia Epidural , Analgesia Obstétrica/métodos , Fator V/genética , Hematoma Epidural Espinal/prevenção & controle , Complicações Hematológicas na Gravidez/genética , Trombofilia/genética , Resistência à Proteína C Ativada/tratamento farmacológico , Adulto , Anticoagulantes/uso terapêutico , Suscetibilidade a Doenças , Enoxaparina/uso terapêutico , Feminino , Heterozigoto , Humanos , Recém-Nascido , Masculino , Anamnese , Gravidez , Complicações Hematológicas na Gravidez/tratamento farmacológico , Punções/efeitos adversos , Fatores de Risco , Trombofilia/tratamento farmacológico , Trombose/prevenção & controleRESUMO
Torsade de pointes is a frequent cause of sudden death of cardiac origin, with uncertain mechanisms of actions and very diverse origins. A case is presented of a patient with a bronchial condition on pharmacological treatment with macrolides, and who, as well as having atrial fibrillation, suffered an episode of self-limiting torsade de pointes that abated spontaneously with no associated clinical complications.