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British Journal of Anaesthesia, Vol 75, Issue 5 639-641, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia

CASE REPORTS

Anaesthetic management of caesarean section in a patient with active recurrent genital herpes and AIDS-related dementia

D. J. Birnbach, R. A. Bourlier, R. Choi and D. M. Thys
Department of Anesthesiology, St Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons of Columbia University, 1000 Tenth Avenue, New York, New York 10019, USA

We report the anaesthetic management of a pregnant patient with multiple manifestations of HIV infection who underwent Caesarean section. A 30-yr-old, HIV-positive, Haitian woman presented with acute psychosis at 28 weeks' gestation. A diagnosis of HIV dementia complex was made and haloperidol therapy was started. Five days after admission the patient was found to be in labour and tocolytic therapy with terbutaline was commenced. A vaginal lesion compatible with herpes simplex virus was observed which was treated with acyclovir. After 3 days of tocolytic therapy there were no further signs of preterm labour. Two weeks later, at 30 weeks' gestation, the patient's membranes ruptured spontaneously. The herpes labialis lesion was still present and urgent Caesarean section was begun using subarachnoid 0.75% bupivacaine 1.5 ml. The patient had no intraoperative problems and a 1700-g healthy male child was delivered.
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S. Evron, M. Glezerman, E. Harow, O. Sadan, and T. Ezri
Human Immunodeficiency Virus: Anesthetic and Obstetric Considerations
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