重症肝障害を来した成人スチル病合併妊婦の帝王切開の麻酔経験

A Case of Cesarean Section in a Pregnant Woman with Adult Still’s Disease Complicated by Severe Liver Injury

要旨

　妊娠経過中に肝障害が生じた場合，妊娠終了を決断するタイミングは肝障害の原因によって異なる。今回，原因不明の重度肝障害を来した成人スチル病合併妊婦の帝王切開を経験した。刻々と進行する肝障害の推移を慎重に観察し，関連各科との連携を密にすることで，最適な麻酔方法を選択し，母児ともに安全に救命しえた。

　When liver injury occurs during pregnancy, the timing of the decision to terminate the pregnancy depends on the cause of the liver injury. This patient for a cesarean section with adult Still’s disease had severe liver injury of unknown cause. By carefully observing the progress of the liver injury and communicating closely with the relevant departments, we were able to choose the most appropriate anesthesia method and saved the lives of both mother and child.