Anesthesia in pregnant women with diastematomyelia. Unusual case

Abstract

Introduction: The diastematomyelia is a rare form of Spinal Dysraphism (less than 3% of the cases with occult spinal Dysraphism), more common in females and children. Clinically presents with three groups of syndromes: skin disorders, orthopedic deformities and signs or symptoms of neurological dysfunction. The obstacles of difficult airway established one of the most consistent sources of morbidity and mortality, among which may be enumerated: limitation of body movements, insufficient mouth opening, representing a narrow trachea and displaced in many occasions, cervical mobility restriction, pulmonary complications and commissural lacerations. Clinical Case: Female patient, 32 years old, diagnosed with Diastematomyelia, term pregnancy of 39.4 weeks which retard the mobilization, restricted ambulation by underlying disease, besides position with lumbar dorsiflexion increased (military position) and dermal pore over the cleft buttock, breathing problems and no tolerance of supine decubitus position, emergency cesarean
was done to her, conduction of difficult airway, intubation using Eschmann Guide, endotracheal tube placement No. 6.0, adequate controlled ventilation, transoperatory hemodynamic stabilization, Anesthetic Recovery without complications. Conclusions: Confronting the airway of obstetric patients, perse, instituting a challenge, added to this the unusual and difficult Diastematomyelia presence is a mesentery for anesthesiologists. To achieve the flattering result of the mother and fetus are targets of primary interest, their satisfactory progress achieved their success.