2014, Number 2
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Mediciego 2014; 20 (2)
Anesthesia in pregnant women with diastematomyelia. Unusual case
Díaz RJH, Llanos PLE, Ayrado NAY, Fonseca LA
Language: Spanish
References: 17
Page:
PDF size: 63.91 Kb.
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.
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