Osteogenesis Imperfecta em obstetrícia: Relato de caso

Abstract

Background and objectives: Osteogenesis Imperfecta is a rare condition, especially in obstetric patients. It has an estimated prevalence of 1/10,000 in the general population, and 1/25,000 to 30,000 in obstetric patients. The objective of this report was to present a rare case of a pregnant woman with Osteogenesis Imperfecta undergoing cesarean section. Case report: This is a 23 years old gravida on the 38 th week, admitted to the maternity ward with loss of amniotic fluid and contractions for four hours, associated with the absence of fetal movements for four days. The patient had a mild form of Osteogenesis Imperfecta without other comorbidities. She was not taking any medication, and she did not have prenatal follow-up. The patient underwent spinal anesthesia in the L 3-L 4 space, median approach, with a single puncture with a 27G Quincke needle and the administration of hyperbaric 0.5% bupivacaine (10 mg) and morphine (60 μg). She was discharged in the second postoperative day without complaints. Conclusions: Fertility is preserved, especially in those patients with type I of the disease, and pregnancy can be carried to term. Delivery is usually surgical due to pelvic deformities in the gravida, cephalopelvic disproportion, and increased incidence of abnormal fetal presentation. The importance of the anesthesiologist in the surgical team relies on the perioperative management and the choice of the most appropriate anesthetic technique for each patient.

Diagnóstico pré-natal da osteogênese imperfeita tipo 2: relato de caso

“…Assim, nos casos de OI tipo 2, o riscobenefício de uma cesariana deve ser abordado nas consultas de pré-natal, explicitando-se que a via de parto parece não alterar o prognóstico do recém-nascido [2]. Da mesma forma, nos tipos não letais de OI, o parto vaginal pode ser uma opção, sem aumento do número de fraturas no feto durante o trabalho de parto e no momento do parto [1].…”

“…A osteogênese imperfeita (OI), ou "doença dos ossos de vidro" é uma patologia do tecido conjuntivo, com incidência de 1:20.000 a 1:50.000 nascidos vivos, que afeta igualmente ambos os sexos e apresenta como principal fator etiológico mutações no gene do colágeno tipo I, as quais causam defeito na sua biossíntese [1,2].…”