Anaesthetic management of a pregnant patient with multiple myeloma

We describe a 42-year-old multiparous woman who was admitted to our hospital in the 28th week of her twin pregnancy because of anaemia and proteinuria. She was subsequently diagnosed with multiple myeloma. An uncomplicated elective caesarean section was performed at 35 weeks under combined spinal–epidural anaesthesia with a good outcome for mother and both babies. After two weeks, however, the mother developed cardiac failure due to peripartum cardiomyopathy. To our knowledge, there have been no more then twenty reports of multiple myeloma in pregnant patients, of which only five have been diagnosed during pregnancy. This is the first case report describing anaesthetic implications and management of a parturient with multiple myeloma.