Familial hypokalemic periodic paralysis and Wolff-Parkinson-White syndrome in pregnancy.
OBJECTIVE
To describe the anesthetic and obstetrical management of a pregnant patient with co-existing Familial Hypokalemic Periodic Paralysis (FHPP) and Wolff-Parkinson-White syndrome (WPW).


METHODS
A 29 yr-old primigravida with FHPP and WPW presented to the antenatal clinic at 18 wk gestation, for consideration of her anesthetic and obstetrical management during labour and delivery. A plan was constructed to avoid the known precipitating factors of FHPP including carbohydrate loading, cold, mental stress and exercise, which could lead to acute attacks of weakness. She presented for induction of labour at 41 wk and three days. An epidural catheter was sited early in labour. The second stage was limited to less than one hour. She had a rotational forceps delivery for which the epidural was extended to provide anesthesia. A healthy male baby was delivered. The patient made an uncomplicated recovery and was discharged home on the second postnatal day. The peripartum potassium was kept within the normal range with intravenous as well as oral potassium supplementation. No arrhythmias were reported.


CONCLUSIONS
Assessment of the patient at an early stage in her pregnancy allowed for a multidisciplinary approach to this patient and her medical problems. A plan was made to avoid known precipitating factors during labour, delivery and the postnatal period well in advance of her date of confinement, leading to a successful outcome for mother and child.
Robinson
J E
JE
Department of Anesthesia, British Columbia Women's Hospital & Health Centre, Vancouver, Canada.
Morin
V I
VI
Douglas
M J
MJ
Wilson
R D
RD
D000328:Adult; D005260:Female; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology*