Authors : Ajit Kumar; Dr. Vigneshwar; Dr. Radheshyam; Dr. Saif Ali Chisti

Volume/Issue : Volume 11 - 2026, Issue 3 - March

Google Scholar : https://tinyurl.com/3c583shw

Scribd : https://tinyurl.com/2yepcd66

DOI : https://doi.org/10.38124/ijisrt/26mar926

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background Multiple myeloma is a malignant disorder characterized by clonal proliferation of plasma cells producing monoclonal immunoglobulins. The disease primarily affects older adults and its occurrence during pregnancy is rare. Anesthetic management in such patients may be challenging due to anemia, renal dysfunction, skeletal involvement, hyperviscosity, and possible coagulation abnormalities.  Case Presentation A 28-year-old Indian primigravida at 37 weeks gestation with recently diagnosed multiple myeloma presented in the late stage of labor and required emergency lower segment cesarean section due to fetal distress. The diagnosis was suspected during evaluation for antenatal anemia. Peripheral blood smear demonstrated rouleaux formation and urine examination detected Bence-Jones proteins. Preoperative investigations showed hemoglobin 8 g/dL, platelet count 1.2 ×10⁵/µL, PT/INR 11.2 s / 0.8, and serum creatinine 1.4 mg/dL suggesting possible renal involvement. Spinal anesthesia was performed at the L4–L5 interspace using 12.5 mg hyperbaric bupivacaine with 20 µg fentanyl through a 26-gauge Quincke needle. Adequate sensory block to T4 dermatome was achieved. Intraoperative hemodynamics remained stable with goal-directed fluid therapy. A healthy neonate weighing 2.5 kg with APGAR score 8/10 was delivered. The perioperative course was uneventful. Written informed consent was obtained from the patient for publication of this case report.  Conclusion Spinal anesthesia may be safely administered for cesarean section in selected parturients with multiple myeloma when coagulation parameters are normal and there is no evidence of spinal involvement. Careful perioperative evaluation and multidisciplinary management are essential.

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