Anesthetic Management of Emergent Uterine Rupture in a 72 Year-old Parturient

One of the more controversial issues in the management of infertility is the problem of a woman’s age. With increasing age greater than 40, the percentage of successful in-vitro fertilization is dramatically reduced.... [ view full abstract ]

One of the more controversial issues in the management of infertility is the problem of a woman’s age. With increasing age greater than 40, the percentage of successful in-vitro fertilization is dramatically reduced. Additionally, both anesthetic and obstetric complication rates increase as the parturient ages. Obstetric complications include increasing rates of preeclampsia, gestational diabetes, pelvic infections, intra-peritoneal bleeding, placenta-previa, and fetal mortality.^1-3 From the anesthesia perspective, the physiology of pregnancy and aging can be in direct conflict, making anesthetic considerations extremely risky and challenging.^5-6 Over the last 20 years pregnancy in women over age 50 has dramatically increased, as there is no legal age limit for in-vitro fertilization in the U.S.⁴ Anesthesiologists and Obstetricians must be cautious and responsible while selecting and treating patients of advanced age with assisted reproductive technology (ART). In this case, we will discuss a 72 year-old parturient who developed a rare life-threatening intra-peritoneal bleed at almost 23 weeks of gestation.