Emergency caesarean section in a poor risk patient in Nepal.

This report describes the management of a poor risk Nepalese patient (active pulmonary tuberculosis, haemoglobin concentration 4.6 g dl-1, weight 28.5 kg) requiring emergency Caesarean section for fetal distress. Subarachnoid blockade (0.5% bupivacaine plain 3.5 ml) was satisfactory; blood loss was around 400 ml and was replaced with Haemaccel and lactated Ringer's solution (blood was not available). Although unresponsive at birth, the child had an Apgar score of 10 at 15 min.