title: [Severe muscular dystrophy and pregnancy: interdisciplinary challenge].
abstract: The muscular dystrophies are degenerative muscle diseases characterized by progressive muscle weakness. The vast majority of women suffering from muscle diseases develop a deterioration of symptoms during pregnancy. Cardiac and respiratory complications are observed in pregnant women with muscular dystrophy especially in the second and third trimester. The successful perioperative therapy of a 32-year-old pregnant tetraplegic woman with a severe limb-girdle type muscular dystrophy who underwent elective Caesarean section is reported. According to the literature epidural and spinal anesthesia are both possible for perioperative anesthetic management in women with limb-girdle dystrophies. Due to the excellent controllability of intrathecal hyperbaric bupivacaine it was decided to use spinal anesthesia and non-invasive positive pressure ventilation was planned in case of impairment of respiratory function. In summary limb-girdle muscular dysthrophies should be managed on an individual basis and spinal anesthesia can be safely used to avoid intubation.
authors: Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. fbreunig@uke.de
authors: F
authors: F
authors: von Breunig
authors: A E
authors: AE
authors: Goetz
authors: K
authors: K
authors: Heckel
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007385:Intermittent Positive-Pressure Ventilation; D016343:Monitoring, Intraoperative; D009136:Muscular Dystrophies / Q000150:complications* / Q000628:therapy; D049288:Muscular Dystrophies, Limb-Girdle / Q000628:therapy; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011782:Quadriplegia / Q000209:etiology
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine