Anesthetic Considerations in a Parturient With Methylmalonic Acidemia: A Case Report

Methylmalonic acidemia (MMA) is an autosomal recessive inborn error of branched-chain amino acid metabolism that leads to an accumulation of methylmalonic acid. This disorder is uncommonly encountered and can pose unique challenges during the peripartum period, specifically surrounding avoidance of catabolic states and metabolic decompensation. In this case report, we describe the preoperative optimization and peripartum considerations required for the successful anesthetic management of a patient with MMA undergoing a primary cesarean delivery.