<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-5830</journal-id>
<journal-title><![CDATA[Acta Obstétrica e Ginecológica Portuguesa]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Obstet Ginecol Port]]></abbrev-journal-title>
<issn>1646-5830</issn>
<publisher>
<publisher-name><![CDATA[Euromédice, Edições Médicas Lda.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-58302022000200150</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Unexpected chronic methemoglobinemia diagnosis in a pregnant patient in labor]]></article-title>
<article-title xml:lang="pt"><![CDATA[Diagnóstico de metahemoglobinémia numa grávida em trabalho de parto]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Branco]]></surname>
<given-names><![CDATA[Rute Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Nelson]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Ana Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Prof. Doutor Fernando Fonseca  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>16</volume>
<numero>2</numero>
<fpage>150</fpage>
<lpage>154</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-58302022000200150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-58302022000200150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-58302022000200150&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Methemoglobinemia is a rare hemoglobinopathy which can complicate pregnancy. The obstetric and anesthetic management of methemoglobin pregnant patients is poorly described. We report a case of a 24-year-old patient admitted in labor, with noticeable cyanosis but no respiratory distress. Oxygen saturation was 86%, remaining unaltered after oxygen therapy. Arterial blood gas showed normoxemia and 24,4% methemoglobin. Efforts were directed at limiting the physiologic stress and oxygen consumption, initiating epidural labor analgesia, and performing a vacuum-assisted vaginal delivery. Mo-ther and baby were discharged after an uneventful hospital stay. The etiologic investigation of cyanosis in this patient revealed this rare hemoglobinopathy.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A metahemoglobinémia é uma hemoglobinopatia rara que pode complicar a gravidez. Na literatura são poucos os casos descritos de grávidas com o diagnóstico de metahemoglobinémia, bem como a sua atuação obstétrica e anestésica. Relatamos o caso de uma paciente de 24 anos internada em trabalho de parto, com cianose, mas sem dispneia. Apresentava uma saturação de oxigénio de 86%, que não se alterou após oxigenoterapia. A gasimetria arterial evidenciou normoxémia e uma metemoglobina de 24,4%. Para limitar o consumo de oxigénio pela grávida foi inicialmente administrado analgesia epidural, e posteriormente realizado um parto instrumentado com ventosa. A mãe e o recém-nascido tiveram alta após um internamento sem intercorrências. A investigação etiológica da cianose revelou esta rara hemoglobinopatia.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Cyanosis]]></kwd>
<kwd lng="en"><![CDATA[Methemoglobinemia]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="pt"><![CDATA[Cianose]]></kwd>
<kwd lng="pt"><![CDATA[Metahemoglobinémia]]></kwd>
<kwd lng="pt"><![CDATA[Gravidez]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neander]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
<name>
<surname><![CDATA[Loner]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Rotoli]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The acute treatment of methemoglobinemia in pregnancy]]></article-title>
<source><![CDATA[J Emerg Med]]></source>
<year>2018</year>
<volume>54</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>685-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[RO]]></given-names>
</name>
<name>
<surname><![CDATA[Lewander W]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Woolf]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Methemoglobinemia etiology, pharmacology, and clinical management]]></article-title>
<source><![CDATA[Ann Emerg Med]]></source>
<year>1999</year>
<volume>34</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>646-56</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nascimento]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mello]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metemoglobinemia: do diagnóstico ao tratamento]]></article-title>
<source><![CDATA[Rev Bras Anestesiol]]></source>
<year>2008</year>
<volume>58</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>651-64</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Warang]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
<name>
<surname><![CDATA[Kedar]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
<name>
<surname><![CDATA[Shanmukaiah]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ghosh]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Colah]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical spectrum and molecular basis of recessive congenital methemoglobinemia in India]]></article-title>
<source><![CDATA[Clin Genet]]></source>
<year>2014</year>
<volume>87</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>62-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Londhey]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Khadilkar]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Gad]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Chawla]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Asgaonkar]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Congenital methemoglobinemia a rare cause of cyanosis in an adult patient]]></article-title>
<source><![CDATA[J Assoc Physicians India]]></source>
<year>2014</year>
<volume>62</volume>
<page-range>269-71</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Verma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sachdeva]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Gandhi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rare Case of Methemoglobinemia Complicating Pregnancy]]></article-title>
<source><![CDATA[Case Rep Obstet Gynecol]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Braatvedt]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acquired methemoglobinaemia in pregnancy A case report]]></article-title>
<source><![CDATA[S Afr Med J]]></source>
<year>1985</year>
<volume>67</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>23-4</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rajabi]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Ale Davood]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vitamin C effect on silver nitrate induced methemoglobinemia Animal study]]></article-title>
<source><![CDATA[J Res Med Sci]]></source>
<year>2001</year>
<volume>6</volume>
<page-range>205-7</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sljapic]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ancic]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Suvakovic]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Gudelj]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pregnancy and hereditary enzymatic methemoglobinemia]]></article-title>
<source><![CDATA[Jugoslavenska Ginekologija i Opstetricija]]></source>
<year>1978</year>
<volume>18</volume>
<numero>3-4</numero>
<issue>3-4</issue>
<page-range>321-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
