///2009 Abstract Details
2009 Abstract Details2019-08-03T15:55:31-06:00

Total Intravenous Anesthesia for Classical Cesarean Section for a Primigravida with Osteogenesis Imperfecta Type I

Abstract Number: 255
Abstract Type: Case Report/Case Series

Abhinava S Madamangalam MB BS, MD1

We detail the clinical history, presentation and anesthetic management of an operative delivery of a 20year old primigravida with type I Osteogenesis Imperfecta (OI) in this poster.

Our patient had been referred to our Maternal Fetal Medicine Division due to her diagnosis of Osteogenesis Imperfecta. She had previously undergone multiple orthopedic surgeries owing to her recurrent fractures. She presented to us during her mid 3rd trimester with new rib fractures resulting from pressure from her expanding uterus.

She had surgically corrected kyphoscoliosis and was wheelchair bound from her spinal deformity. Her history included the fact that some of her spinal hardware was not firmly in position.

The patients mother also was afflicted by Osteogenesis imperfecta, and her unborn child at mid 3rd trimester had a long bone fracture that was highly suspicious of the fetus suffering from one of the forms of OI.

Significant to anesthetic delivery was her history that during a past surgery, that she had significant cardiac arrhythmia and that had required some form of electrical conversion to normal rhythm.

The obstetric plan was to perform a classical cesarean section in an effort to minimize fetal trauma.

We will detail our anesthetic concerns for safe anesthetic including appropriate monitoring, atraumatic positioning, airway assessment and issues relating to intubation of patients with OI. Our choice and method of performing a total intravenous anesthetic for the cesarean section that followed.

We will include a brief discussion of the effect of pregnancy and lactation on OI. And follow with literature review of TIVA for cesarean section, and special considerations for delivering safe anesthesia for patients with OI.

SOAP 2009