LABOR ANALGESIA IN A PATIENT WITH CARNITINE PALMITYL TRANSFERASE DEFICIENCY AND IDIOPATHIC THROMBOCYTOPENIC PURPURA

We report a case of a woman with carnitine palmityl deficiency (CPT) a nd idiopathic thrombocytopenic purpura, presenting in active labour at 38 weeks gestation. We discuss different anaesthetic factors involved with both diseases, and we propose an optimal management of such case s. Neuraxial analgesia with minimal motor blockade is indicated in ear ly labour because it is necessary to alleviate stress in order to avoi d rhabdomyolisis associated with CPT deficiency. Neuraxial analgesia i s also needed because the theoretical risk of performing a caesarean s ection is higher than in a normal population, first because labour mus t be kept as short as possible and secondly because the possible throm bocytopenia in the baby precludes the use of instrumental delivery.