Management of Anesthesia During Splenectomy and Cholecystectomy in a Pregnant Woman With Hereditary Spherocytosis

Hereditary spherocytosis (HS) is a familial hemolytic disorder with intracorpuscular mechanism that characterized by the production of red blood cells with sphere-like shape prone to hemolysis and can lead to hemolytic anemia, splenomegaly, jaundice and gallstones. One of the main reasons for referring these patients to the operating room is splenectomy and cholecystectomy to treat the complications of HS. Perioperative concerns in these patients include severe anemia with a need for blood transfusion, aplastic attacks, hypoxemia and acidosis. On the other hand, management of anesthesia during splenectomy and cholecystectomy in pregnant woman with HS is very challenging due to physiological changes associated with pregnancy, choosing the appropriate time to perform the surgeries, and complications of anesthesia drugs on mother and fetus. This case study report the management of anesthesia in a pregnant woman with HS, candidate for simultaneous cholecystectomy and splenectomy.