Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Int J Obstet Anesth. 2011 Jan;20(1):82-5. doi: 10.1016/j.ijoa.2010.09.004. Epub 2010 Dec 4.
Klippel-Feil syndrome is believed to occur from failure of normal segmentation of cervical somites during gestation. We present the case of a 38-year-old primiparous woman with type III Klippel-Feil syndrome for elective cesarean delivery. Our patient had a short webbed neck, short stature, limited neck flexion and extension, and thoraco-lumbar abnormalities. A multidisciplinary approach, involving obstetrics, medical subspecialties, anesthesiology, otolaryngology, and radiology, were utilized to evaluate and manage this patient. Pulmonary function testing revealed a restrictive defect, but transthoracic echocardiography was normal without pulmonary hypertension. We planned a combined spinal-epidural technique; however, only the epidural technique was obtained. Cesarean delivery was commenced with favorable maternal and fetal outcomes. Post-operative pain management was provided with intravenous morphine patient-controlled analgesia.
克莱佩尔-费尔综合征被认为是由于妊娠期间颈椎体节的正常分割失败而发生的。我们报告了一例 38 岁的 III 型克莱佩尔-费尔综合征初产妇行择期剖宫产的病例。我们的患者颈短、身材矮小、颈部屈伸受限、胸腰椎异常。多学科方法，包括产科、医学亚专科、麻醉学、耳鼻喉科和放射科，用于评估和管理该患者。肺功能检查显示存在限制性缺陷，但经胸超声心动图正常，无肺动脉高压。我们计划采用联合腰麻-硬膜外技术，但仅获得了硬膜外技术。剖宫产开始时母婴结局良好。术后疼痛管理采用静脉注射吗啡患者自控镇痛。
