Emergency cesarean section in an epidemic of the middle east respiratory syndrome: a case report

Park, Mi Hye; Kim, Hee Ryun; Choi, Duck Hwan; Sung, Ji Hee; Kim, Jong Hwa

We performed an emergency C-sec in a patient with a highly infectious respiratory viral pathogenic disease. Sudden placental abruption occurred at midnight, and an immediate C-sec was recommended [5] . Our multidisciplinary team had discussed the delivery and had developed emergency scenarios; thus, the C-sec progressed without delay under the regional anesthesia (RA) for several reasons. She was not actively bleeding, and only moderate variability in FHR was detected without deceleration, so we had ample time to perform the CSE. Although the decision-to-deliver interval for general anesthesia (GA) is faster than that for RA [6] , RA is preferred to GA because it is safer and causes less maternal and neonatal morbidity than those of GA [6, 7] . The other consideration in this case was spread of the infection. Although her chest X-ray and laboratory results improved, the patient had pneumonia within 2 weeks. We were not convinced that the lung parenchyma had fully recovered, and tracheal intubation/extubation in a patient with MERS could expose the medical staff to a high aerosolized viral load. Thus, the C-sec was performed by an experienced senior anesthesiologist.