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Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome

INTRODUCTION: Klippel–Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as those more frequent complications in pregnant patients. Pregnancy is not advised in w...

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Autores principales: Teixeira, Clara Elisa Frare de Avelar, Braga, Angélica de Fátima de Assunção, Braga, Franklin Sarmento da Silva, Carvalho, Vanessa Henriques, Costa, Rafael Miranda da, Brighenti, Giselle Ioná Teixeira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391699/
https://www.ncbi.nlm.nih.gov/pubmed/29506860
http://dx.doi.org/10.1016/j.bjane.2018.01.019
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author Teixeira, Clara Elisa Frare de Avelar
Braga, Angélica de Fátima de Assunção
Braga, Franklin Sarmento da Silva
Carvalho, Vanessa Henriques
Costa, Rafael Miranda da
Brighenti, Giselle Ioná Teixeira
author_facet Teixeira, Clara Elisa Frare de Avelar
Braga, Angélica de Fátima de Assunção
Braga, Franklin Sarmento da Silva
Carvalho, Vanessa Henriques
Costa, Rafael Miranda da
Brighenti, Giselle Ioná Teixeira
author_sort Teixeira, Clara Elisa Frare de Avelar
collection PubMed
description INTRODUCTION: Klippel–Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as those more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetrical risk. CASE REPORT: Female patient, 29 years old, 99 kg, 167 cm, BMI 35.4 kg.m(−2), physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel–Trenaunay syndrome. She was admitted to attempt inhibition of preterm labor. As manifestations of Klippel–Trenaunay syndrome, the patient presented with cerebral and cutaneous hemangioma mainly in the trunk and lumbar region, paresis in the left upper and lower limbs, and limb asymmetry requiring the use of a walking stick. Physical examination revealed absence of airway vascular malformations and Mallampati class 3. Laboratory tests were normal and abdominal angiotomography showed irregular uterus, with multiple varices and vessels of arterial origin and bilateral periadnexal varices. She evolved with failure in preterm labor inhibition, and cesarean section under total intravenous anesthesia was indicated. Monitoring, central and peripheral venous access, radial artery catheterization, and diuresis were secured. Cesarean section was performed with median incision and longitudinal uterine body section for fetal extraction. Two episodes of arterial hypotension were seen intraoperatively. The postoperative evolution was uneventful. The choice of anesthesia was dependent on the clinical manifestations and the lack of imaging tests proving the absence of neuraxial hemangiomas.
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spelling pubmed-93916992022-08-21 Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome Teixeira, Clara Elisa Frare de Avelar Braga, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Carvalho, Vanessa Henriques Costa, Rafael Miranda da Brighenti, Giselle Ioná Teixeira Braz J Anesthesiol Clinical Information INTRODUCTION: Klippel–Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as those more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetrical risk. CASE REPORT: Female patient, 29 years old, 99 kg, 167 cm, BMI 35.4 kg.m(−2), physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel–Trenaunay syndrome. She was admitted to attempt inhibition of preterm labor. As manifestations of Klippel–Trenaunay syndrome, the patient presented with cerebral and cutaneous hemangioma mainly in the trunk and lumbar region, paresis in the left upper and lower limbs, and limb asymmetry requiring the use of a walking stick. Physical examination revealed absence of airway vascular malformations and Mallampati class 3. Laboratory tests were normal and abdominal angiotomography showed irregular uterus, with multiple varices and vessels of arterial origin and bilateral periadnexal varices. She evolved with failure in preterm labor inhibition, and cesarean section under total intravenous anesthesia was indicated. Monitoring, central and peripheral venous access, radial artery catheterization, and diuresis were secured. Cesarean section was performed with median incision and longitudinal uterine body section for fetal extraction. Two episodes of arterial hypotension were seen intraoperatively. The postoperative evolution was uneventful. The choice of anesthesia was dependent on the clinical manifestations and the lack of imaging tests proving the absence of neuraxial hemangiomas. Elsevier 2018-07-13 /pmc/articles/PMC9391699/ /pubmed/29506860 http://dx.doi.org/10.1016/j.bjane.2018.01.019 Text en © 2018 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Information
Teixeira, Clara Elisa Frare de Avelar
Braga, Angélica de Fátima de Assunção
Braga, Franklin Sarmento da Silva
Carvalho, Vanessa Henriques
Costa, Rafael Miranda da
Brighenti, Giselle Ioná Teixeira
Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title_full Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title_fullStr Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title_full_unstemmed Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title_short Anesthesia for cesarean delivery in a patient with Klippel–Trenaunay syndrome
title_sort anesthesia for cesarean delivery in a patient with klippel–trenaunay syndrome
topic Clinical Information
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391699/
https://www.ncbi.nlm.nih.gov/pubmed/29506860
http://dx.doi.org/10.1016/j.bjane.2018.01.019
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