Neuraxial analgesia in a parturient with the VACTERL association undergoing labor and vaginal delivery

Ramos, Jonathan Hernández; Shettar, Shashank S.; James, Christopher F.

doi:10.1016/j.bjane.2016.05.002

Cited by 4 publications

(5 citation statements)

References 11 publications

(18 reference statements)

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“…There are several case reports of the management parturients with VACTERL association, but our case was also complicated by severe cervical spine stenosis. Ramos et al described one such case of a patient with VACTERL association and severe lumbar scoliosis: the patient had an epidural for labour analgesia and an uneventful vaginal delivery [2]. The authors did not state if MRI of the spine was performed.…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of a parturient with VACTERL association for a caesarean section

Tonks

Birch

Ito

et al. 2023

Anaesthesia Reports

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Summary A parturient with VACTERL association (vertebral defects, anal atresia, cardiac defects, trachea‐oesophageal fistula, renal abnormalities and limb abnormalities) was listed for an elective caesarean section. She had a short neck with reduced cervical extension and flexion. Magnetic resonance imaging of her whole spine was performed which showed failure of cervical spine segmentation and cervical stenosis. Neuraxial blockade could have resulted in unpredictable spread of local anaesthetic due to the low volume of the spinal canal, and could have caused myelopathic changes within the spinal cord due to cerebrospinal fluid pressure changes. A general anaesthetic using a rapid sequence induction was also predicted to be challenging due to her fixed, unstable neck and severe cervical spine stenosis. After a multidisciplinary discussion Including neurosurgeons, we planned for awake tracheal intubation followed by general anaesthesia. However, before the date of her planned delivery, she required an urgent caesarean section due to severe preeclampsia. This was performed under general anaesthesia following uncomplicated awake tracheal intubation.

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Section: Discussionmentioning

confidence: 99%

Perioperative management of a parturient with VACTERL association for a caesarean section

Tonks

Birch

Ito

et al. 2023

Anaesthesia Reports

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“…Cardiac anomalies occur in 50%–80% of cases as VSD, ASD, and tetrology of Fallot, being frequently reported defects. [8] Tracheoesophageal anomalies comprises 50%–70% of patients and they may be associated with lung anomalies. Limb anomalies occur in 40%–55% of patients and include radial ray deformities, club foot, hypoplasia of great toe/tibia and lower limb, and tibial deformities.…”

Section: Discussionmentioning

confidence: 99%

VACTERL association – Ultrasound findings and autopsy correlation

Gaur

Gokhale

2018

Indian Journal of Radiology and Imaging

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VACTERL (vertebral, anal, cardiac, tracheoesophagus, renal, and limbs) is an abbreviation for the congenital group of abnormalities, including vertebral or vascular anomalies, anal atresia, cardiac defects, tracheoesophageal – fistula/esophageal atresia, renal defects, and limbs defects. It is a rare association and not accidental event where several organs are affected by developmental defects during blastogenesis. The exact cause is unknown; however, several environmental and genetic factors are included in literature. Three components out of seven are used to label as VACTERL. The combination is necessary, but the patient may have other congenital malformations as well. We present here an antenatal scan with autopsy correlation of one of the forms of VACTERL association spectrum.

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“…8 Cardiac anomalies occur in 50-80% of cases further VSD, ASD, (finding of our case) and tetrology of Fallot are amongst the frequently reported defects. 3 Tracheo-esophageal anomalies occur in approximately 50-70% of patients and they may be associated with lung anomalies. Limb anomalies are reported in approximately 40-55% patients and include radial ray deformities, (absent radius, polydactyly, syndactyly, radioulnar synostosis) club foot, hypoplasia of great toe/tibia and lower limb tibial deformities.…”

Section: Discussionmentioning

confidence: 99%

“…2 It is diagnosed by the simultaneous presence of at least three out of the six VACTERL acronym anomalies without clinical or laboratory evidence suggesting other differential diagnosis. 3…”

Section: Introductionmentioning

confidence: 99%

Neonate with VACTERL association: a rare entity

Chauhan¹,

Garg²,

Kumar³

et al. 2017

Int J Contemp Pediatr

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VACTERL (Vertebral, anal, cardiac, tracheoesophageal, renal and limb) is an acronym for cluster of congenital malformations including Vertebral or Vascular anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula/Esophageal atresia, Renal and Limb defects. It is a rare association with sporadic and non-random occurrence where multiple organs are affected due to developmental defect during blastogenesis. Exact cause is unknown but multiple environmental and genetic factors have been implicated. For diagnosis, three components of VACTERL association are needed however patient may have other congenital malformations also. Here we report a newborn with VACTERL association born to a healthy mother by cesarean section for polyhydramnios with unstable lie.

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Neuraxial analgesia in a parturient with the VACTERL association undergoing labor and vaginal delivery

Abstract: 2017-08-30T02:05:05

Cited by 4 publications

References 11 publications

Perioperative management of a parturient with VACTERL association for a caesarean section

Perioperative management of a parturient with VACTERL association for a caesarean section

VACTERL association – Ultrasound findings and autopsy correlation

Neonate with VACTERL association: a rare entity

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