Patient with Persistent Low Oxygen Saturation for Emergency Cesarean Section.

Area of Science:

• Anesthesiology
• Hematology
• Obstetrics

Background:

• Congenital methemoglobinemia is a rare inherited disorder affecting hemoglobin.
• It can lead to persistent cyanosis and hypoxemia, often presenting subtly.

Observation:

• A 24-year-old woman with undiagnosed congenital methemoglobinemia underwent emergency cesarean section.
• She exhibited persistent low oxygen saturation despite normal vital signs and asymptomatic presentation.

Findings:

• Intraoperative and postoperative monitoring revealed consistently low oxygen saturation.
• Postoperative mass spectrophotometry confirmed the diagnosis of methemoglobinemia.

Implications:

• This case underscores the importance of considering rare hematological conditions in pregnant patients with unexplained hypoxemia.
• Accurate diagnosis of methemoglobinemia is crucial for appropriate management during pregnancy and surgery.
• Highlights challenges in pulse oximetry interpretation in the presence of methemoglobinemia.