Anesthetic and obstetric considerations in a parturient with Klippel-Trenaunay syndrome

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Michael J Sivaprakasam, James A Dolak

Abstract

To explain the considerations governing the anesthetic management of pregnant patients with Klippel-Trenaunay syndrome (KTS). Klippel-Trenaunay syndrome is a congenital vascular disease characterized by cutaneous hemangiomas, venous varicosities, and limb hypertrophy; and is associated with both hemorrhagic and thrombotic complications. The importance of this diagnosis, including the presence of neuraxial vascular anomalies, is often under-appreciated by both obstetric and anesthesia providers. While regional anesthetic management of patients with KTS has been discussed by others, we present a case in which regional anesthesia presented an unwarranted risk to the patient. An obese, 18-yr-old parturient with a fetus in the breech position underwent Cesarean delivery at 35 weeks gestation secondary to evolving preeclampsia. Unfortunately, no neurovascular imaging of this patient's spine was available. The patient underwent an attempted external cephalic version, a failed obstetric induction, and, ultimately, a Cesarean delivery under general anesthesia. The resulting infant was without any stigmata of KTS. Both mother and infant did well during the course of their hospitalization, and were discharged home without incident. The po...Continue Reading

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Citations

Jan 7, 2011·Obstetrics and Gynecology International·Tuğba Güngor Gündoğan, Y Jacquemyn
Jan 28, 2014·Journal de gynécologie, obstétrique et biologie de la reproduction·A KochI Nisand
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Aug 17, 2018·Case Reports in Obstetrics and Gynecology·Rati Chadha

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