ANESTHETIC MANAGEMENT OF CESAREAN-SECTION IN A PATIENT WITH ACTIVE RECURRENT GENITAL HERPES AND AIDS-RELATED DEMENTIA

We report the anaesthetic management of a pregnant patient with multip le manifestations of HIV infection who underwent Caesarean section. A 30-yr-old, HIV-positive, Haitian woman presented with acute psychosis at 28 weeks' gestation. A diagnosis of HIV dementia complex was made a nd haloperidol therapy was started. Five days after admission the pati ent was found to be in labour and tocolytic therapy with terbutaline w as commenced. A vaginal lesion compatible with herpes simplex virus wa s observed which was treated with acyclovir. After 3 days of tocolytic therapy there were no further signs of preterm labour. Two weeks late r, at 30 weeks' gestation, the patient's membranes ruptured spontaneou sty. The herpes labialis lesion was still present and urgent Caesarean section was begun using subarachnoid 0.75% bupivacaine 1.5 ml. The pa tient had no intraoperative problems and a 1700g healthy male child wa s delivered.