title: Neuraxial analgesia in a pregnant woman with Fowler's syndrome and sacral neuromodulation.
abstract: We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. When the patient was admitted for labor, an epidural catheter was placed successfully. The patient had a normal vaginal delivery. Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled. The baby continues to develop normally three years after delivery.
authors.affiliation: Department of Anesthesia and Pain Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ansó
authors.affiliation: Department of Anesthesia and Pain Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain. Electronic address: noraveigagil@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Veiga-Gil
authors.affiliation: Department of Anesthesia and Pain Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: De Carlos
authors.affiliation: Department of Urology, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Hualde
authors.affiliation: Department of Pain Medicine, Hospital General Médico-Quirúrgico, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pérez-Cajaraville
mesh_terms: D000293:Adolescent; D016362:Analgesia, Obstetrical / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010347:Patient Care Planning; D011247:Pregnancy; D011256:Pregnancy Outcome; D019736:Prostheses and Implants; D012447:Sacrum; D013577:Syndrome; D014463:Ultrasonography; D016055:Urinary Retention / Q000000981:diagnostic imaging / Q000628:therapy*; D014554:Urination
keywords: Fowler’s syndrome; Neuraxial anesthesia; Sacral neuromodulation