Emergent cesarean delivery under spinal anesthesia for a patient with hemoglobin Beth Israel: a case report.

A 20-year-old primigravida with hemoglobin Beth Israel, a rare low oxygen-affinity hemoglobinopathy, presented for emergency cesarean delivery with cyanosis and low oxygen saturation. Spinal anesthesia with supplemental oxygen maintained a stable intraoperative and postoperative course, with good maternal and neonatal outcomes. Low oxygen-affinity hemoglobinopathies are often overlooked during evaluation of cyanosis. Understanding the pathophysiology of oxygen delivery in this condition is essential for targeted perioperative care, as obstetric patients may have an elevated risk of hypoxia. Neuraxial anesthesia and supplemental oxygen may help optimize maternal oxygen supply-demand balance. Vigilance for cyanosis, prompt diagnostic evaluation, and oxygen therapy are important in management.