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hand woman trunk leg sitting father 962112 copyPregnancy with achondroplasia may be scary: breathing during the third trimester may not be easy, especially for someone with severe kyphoscoliosis, cesarean section is inevitable, due to the small pelvis, premature delivery is common and anesthesia can be a complicated  [1 - 3].

However, it is possible to give birth in full term and there are alternatives when it comes to anesthesia.

Here we present two case reports on deliveries in women with achondroplasia. The first one by Dubiel, L., et al. (2014). "Achondroplasia: anaesthetic challenges for caesarean section." International Journal of Obstetric Anesthesia 23(3): 274-278, reported difficulty in breathing since early in pregnancy (11 weeks) and most severe during the third trimester, which was exacerbated by severe anxiety and led to an early cesarean section at 32 weeks.

Neuraxial anesthesia is considered technically difficult, due to a narrow spinal canal and possible spinal anomalies, such as stenosis and kyphoscoliosis, and is also associated to neurological complications [3].

Because of this, general anesthesia is usually the preferred option, even though technical challenges in this procedure have also been reported, due to cervical instability, macroglossia, and limited cervical extension. There is no guideline for the mode of anesthesia and the method used should be selected depending on the patient. In both reported cases general anesthesia was performed with no difficulties in intubation or manual respiration [1, 2].

The second case resulted in a full term pregnancy with a delivery at 37 weeks of a healthy baby, showing that it's possible for a woman with achondroplasia to deliver a baby close to the expected due date with careful monitoring [2].

baby small
Sources

  1. Dubiel, L., et al. (2014). "Achondroplasia: anaesthetic challenges for caesarean section." International Journal of Obstetric Anesthesia 23(3): 274-278.
  2. Shirazi, M., Golshahi, F., & Teimoory, N. (2017). Successful Delivery in a Woman With Achondroplasia: A Case Report. Acta Medica Iranica, 55(8), 536-537.
  3. Speulda, F.O.E. Anesthesia recommendations for patients suffering from Achondroplasia. 2011 [cited 2017 22/08].
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