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Management of labor analgesia in a patient with acute myeloid leukemia

Kelly G Elterman1, Jonathan R Meserve, Martha Wadleigh

  • 1From the *Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; and †Hematology-Oncology, Dana Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.

A & a Case Reports
|January 23, 2015
PubMed

The anesthetic implications of acute leukemia in pregnancy have not been reported. We describe the anesthetic management of a laboring primigravida at 34 weeks' gestation with new-onset acute myeloid leukemia. With multidisciplinary consultation, we recommend that neuraxial anesthesia be avoided in new-onset acute myeloid leukemia due to the risk of introducing malignant cells into the central nervous system, which can spread the disease and complicate management. We discuss the use of a fentanyl patient-controlled analgesia and dexmedetomidine as a method of labor analgesia, and the potential benefits of the latter medication in the obstetric population.

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