From the Department of Anesthesiology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois.
A A Pract. 2021 Aug 4;15(8):e01506. doi: 10.1213/XAA.0000000000001506.
Neurologic conditions without prenatal optimization can pose anesthetic and obstetrical challenges. We present a case of Currarino syndrome; an autosomal dominant triad of agenesis of the sacrum, anterior sacral meningocele (ASM) with sacral teratomas, and anorectal stenosis; diagnosed during pregnancy; and the subsequent anesthetic considerations. The location, size, and risk of rupture of the ASM can create obstacles to delivery. Eligibility for neuraxial anesthesia should be made on a case-by-case basis with risk-benefit analysis, and deficits should be documented allowing prompt identification and intervention should complications arise. Multidisciplinary team coordination is vital to help facilitate maternal safety.
没有产前优化的神经状况可能会带来麻醉和产科方面的挑战。我们介绍了一例 Currarino 综合征病例；这是一种常染色体显性三联征，包括骶骨发育不全、前骶膜脑膜膨出（ASM）伴骶尾部畸胎瘤和直肠肛门狭窄；在妊娠期间诊断出；并随后考虑麻醉问题。ASM 的位置、大小和破裂风险会给分娩带来障碍。是否有资格进行脊柱麻醉应根据具体情况进行风险效益分析，并应记录缺陷，以便在出现并发症时能够迅速识别和干预。多学科团队协调对于帮助确保产妇安全至关重要。
