///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

It takes a village: a multidisciplinary approach to caring for a parturient with pulmonary AVMs

Abstract Number: RF3BC-489
Abstract Type: Case Report Case Series

Kymberlee Royals MD1 ; Bryn Carpenter MD2

Parturients with hereditary hemorrhagic telangiectasia are rare and can manifest with arteriovenous malformations (AVMs) in the lungs, brain, and spine. This complexity warrants forethought, and will require additional time and collaboration for successful anesthetic management. We present a case of a 29 year-old female G4P3002 at 29w0d presenting to labor and delivery triage with acute onset dyspnea, transient aphasia, and right hand weakness. On exam she was hypoxic with a grossly normal neurological exam. Pulmonary work-up included a computed tomography angiography, which revealed multiple AVMs. Neurological workup revealed old cerebral infarcts and tortuosity of the anterior communicating artery. She underwent IR embolization of the two pulmonary AVMs prior to an uneventful vaginal delivery at full term without anesthetic intervention. This case emphasizes the importance of developing a multidisciplinary team approach to optimize the management plan in complex clinical cases.

SOAP 2019