Term Pregnancy in an Achondroplastic Dwarf: A Case Report.

ABSTRACT

Achondroplasia is a rare disorder occurring in 1 in 15,000 to 1 in 40,000 live births. However, it is the commonest disorder among more than 100 different types of dwarfism. It is inherited as an autosomal dominant trait but most cases (80%) are due to mutations of fibroblast growth factor receptor 3 (FGFR3). These individuals have normal mental and sexual development and life-span may also be normal. However, problems such as pre-eclampsia, polyhydramnios, respiratory compromise, contracted pelvis necessitating lower-segment cesarean section, prematurity and fetal wastage, etc., have been reported. General anesthesia is preferred to regional anesthesia because of spinal abnormalities. The aim of this report is to describe the surgical management of these patients discussing the surgical consideration and emphasizing the difficulties encountered. Such a patient is considered high-risk in terms of anesthesia and obstetric outcome. A case of achondroplasia with pregnancy is reported. A 28-year-old achondroplastic parturient underwent cesarean section under general anesthesia for contracted pelvis. We did not encounter problems related to cesarean section. The most important point is the careful preoperative assessment. Anesthesia plan should be specified to individual basis.