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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

Thinking outside of the blue box: a case presentation of neonatal methemoglobinemia

Journal of Perinatology volume 33, pages 903–904 (2013)Cite this article

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Abstract

We report the case of a full-term neonate who presented with cyanosis from birth secondary to methemoglobinemia precipitated by the obstetric use of bupivacaine in a spinal anaesthetic for caesarean delivery.

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References

  1. Chou TD, Gibran NS, Urdahl K, Lin EY, Heimbach DM, Engrav LH . Methemoglobinaemia secondary to topical silver nitrate therapy - a case report. Burns 1999; 25 (6): 549–552.

    Article  CAS  Google Scholar 

  2. Couper RT . Methemoglobinemia secondary to topical lignocaine/prilocaine in a circumcised neonate. J Paediatr Child Health 2000; 36: 406–407.

    Article  CAS  Google Scholar 

  3. Dahshan A, Donovan GK . Severe methemoglobinemia complicating topical benzocaine use during endoscopy in a toddler: a case report and review of the literature. Pediatrics 2006; 117 (4): e806–e809.

    Article  Google Scholar 

  4. Kuhnert B, Zuspan K, Kuhnert P, Syracuse C, Brown D . Bupivacaine disposition in mother, fetus, and neonate after spinal anesthesia for caesarean section. Anesthesia & Analgesia 1987; 66 (5): 407–412.

    Article  CAS  Google Scholar 

  5. McGuinness G, Merkow A, Kennedy R, Erenberg A . Epidural anesthesia with bupivacaine for cesarean section: neonatal blood levels and neurobehavioral responses. Anesthesiology 1978; 49 (4): 270–273.

    Article  CAS  Google Scholar 

  6. Johnson RF, Herman NL, Johnson HV, Arney TL, Paschall RL, Downing JW . Effects of fetal pH on local anesthetic transfer across the human placenta. Anaesthesiology 1996; 85 (3): 608–615.

    Article  CAS  Google Scholar 

  7. Miller DR . Hemolytic anemias-metabolic defects In: Miller D, Baehner R (eds) Blood Diseases of Infancy and Childhood 6th ed C.V Mosby Company: St Louis, 1990 pp 294–357.

    Google Scholar 

  8. Hjelt K, Lund JT, Scherling B, Bendixen S, Lundstrøm K, Støvring S et al. Methemoglobinemia among neonates in a neonatal intensive care unit. Acta Paediatr 1995; 84: 365–370.

    Article  CAS  Google Scholar 

  9. Nilsson A, Engberg G, Henneberg S, Danielson K, De Verdier CH . Inverse relationship between age-dependent erythrocyte activity of methemoglobin reductase and prilocaine-induced. methemoglobinemia during infancy. Br J Anaesth 1990; 64 (1): 72–76.

    Article  CAS  Google Scholar 

  10. Santhanam S, Cote CJ . Local anesthetic solutions for regional anesthesia in infants, children and adolescents In: Sumner JY, Jacob VA (eds), Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice 4th ed Lippincott Williams & Wilkins: Philidelphia, 2011; p705.

    Google Scholar 

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Acknowledgements

We acknowledge the family for providing consent to write this case report.

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Homerton University Hospital, Homerton Row, London, UK

    M van de Vijver, E Parish & N Aladangady

  2. Paediatric Department, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

    N Aladangady

  3. Department of Child Health, SDM College of Medical Sciences and Hospital Dharwad, Dharwad, India

    N Aladangady

Authors
  1. M van de Vijver
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  2. E Parish
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  3. N Aladangady
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Correspondence to M van de Vijver.

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The authors declare no conflict of interest.

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van de Vijver, M., Parish, E. & Aladangady, N. Thinking outside of the blue box: a case presentation of neonatal methemoglobinemia. J Perinatol 33, 903–904 (2013). https://doi.org/10.1038/jp.2013.74

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  • DOI: https://doi.org/10.1038/jp.2013.74

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