Management of a parturient with thrombocytopenia-absent-radius syndrome undergoing urgent caesarean section

Thrombocytopenia-absent-radius syndrome is a rare congenital condition characterised by a low platelet count and limb abnormalities. There may be airway difficulties and cardiac disease is frequently associated. We present a case of successful general anaesthesia for urgent caesarean section. The major anaesthetic difficulties encountered were severe thrombocytopenia with a platelet count 30x10(9)/L, which precluded regional anaesthesia, and extensive limb abnormalities resulting in difficulty with vascular access and cardiovascular monitoring. Platelet transfusion was required but airway difficulties were not encountered.