Achondroplasia: anaesthetic challenges for caesarean section

Abstract Pregnancy in women with achondroplasia presents major challenges for anaesthetists and obstetricians. We report the case of a woman with achondroplasia who underwent general anaesthesia for an elective caesarean section. She was 99 cm in height and her condition was further complicated by s...

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2014-08, Vol.23 (3), p.274-278
Main Authors: Dubiel, L, Scott, G.A, Agaram, R, McGrady, E, Duncan, A, Litchfield, K.N
Format: Article
Language:English
Subjects:
Achondroplasia
Achondroplasia - complications
Androstanols
Anesthesia & Perioperative Care
Anesthesia, General
Anesthesia, Obstetrical
Anesthetics, Intravenous
Caesarean section
Cesarean Section - methods
Female
General anaesthesia
Humans
Infant, Newborn
Neuromuscular Nondepolarizing Agents
Obstetrics and Gynecology
Patient Care Team
Piperidines
Pregnancy
Remifentanil
Rocuronium
Scoliosis - complications
Young Adult
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Summary:Abstract Pregnancy in women with achondroplasia presents major challenges for anaesthetists and obstetricians. We report the case of a woman with achondroplasia who underwent general anaesthesia for an elective caesarean section. She was 99 cm in height and her condition was further complicated by severe kyphoscoliosis and previous back surgery. She was reviewed in the first trimester at the anaesthetic high-risk clinic. A multidisciplinary team was convened to plan her peripartum care. Because of increasing dyspnoea caesarean section was performed at 32 weeks of gestation. She received a general anaesthetic using a modified rapid-sequence technique with remifentanil and rocuronium. The intraoperative period was complicated by desaturation and high airway pressures. The woman’s postoperative care was complicated by respiratory compromise requiring high dependency care.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2014.02.002