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Chapter 11 - Parturients of Short Stature

Published online by Cambridge University Press:  26 January 2024

By
Robert French-O’Carroll ,
Katherine M. Seligman  and
Andrea J. Traynor
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Grace Lim
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Grace Lim
Affiliation:
University of Pittsburgh
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Summary

Short stature (height < 148 cm) is caused by a heterogeneous mix of conditions with genetic, constitutional, or metabolic origins. It can be classified into conditions causing proportionate or disproportionate short stature depending on the trunk-limb ratio. Disproportionate short stature is largely due to the skeletal dysplasia disorders, of which achondroplasia is the most common condition. Pregnancy and delivery are high risk periods in these patients given the increased risk of cardiorespiratory compromise from the physiological changes in pregnancy in addition to the high risk of cesarean deliveries from cephalopelvic disproportion and decompensated maternal and fetal conditions. Anesthesia management is challenging as anatomic abnormalities result in increased difficulty and increased risk of complications with both neuraxial and general anesthesia. There are also challenges around use of equipment, intraoperative monitoring, dosing of neuraxial anesthesia agents and postoperative management. Despite these difficulties there is a significant number of reports in the literature on the successful management of parturients with short stature. These reports can help guide anesthesiologists in ensuring the safe care of this unique patient population.

Keywords

proportionate short staturedisproportionate short statureachondroplasiaskeletal dysplasiaosteogenesis imperfectacatheter-based neuraxial anesthesia
Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 140 - 158
Publisher: Cambridge University Press
Print publication year: 2024

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