Anaesthetic Management of Parturient with Sickle Cell Disease and Uncontrolled Hypothyroidism for Emergency Appendicectomy

Sickle cell disease (SCD) is a rare clinical disorder characterised by chronic anaemia and episodes of vaso-occlusive crisis. Hypothyroid patients need additional levothyroxine supplementation during pregnancy¹. Physiological changes of pregnancy add on to stress and may precipitate vaso-occlusive crisis and result in significant cardiorespiratory complications². Surgery and anaesthesia during first trimester of pregnancy is avoided due to risk of miscarriage.