Anesthesia in a parturient with osteogenesis imperfecta for cesarean section

ABSTRACT

Osteogenesis imperfecta is a rare inherited connective tissue disorder that presents with skeletal deformities and extraskeletal abnormalities. Pregnancy superimposed on existing osteogenesis imperfecta has a significantly increased maternal and fetal morbidity, hence presents multiple unique anesthetic challenges. A 25- year old term primigravid previously diagnosed with osteogenesis imperfecta and muscular dysthrophy presents for cesarean section. Important considerations in the management of this patient included anesthetic choice with their corresponding advantages and possible complications, patient positioning, intraoperative monitoring and possibility of difficult airway. Knowledge of the physiologic and anatomic abnormalities of the individual patients as well as understanding the advantages and complications associated with both regional and general anesthesia are thus crucial in formulating the appropriate anesthetic management plan that would ensure safety of both mother and child.