A & A case reports
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Blue rubber bleb nevus syndrome, a syndrome of multifocal venous malformations, has been reported rarely during pregnancy. This syndrome has been associated with airway lesions in some patients and neuraxial abnormalities in other patients. We report the anesthetic and obstetric management of a patient with an extensive distribution of both airway and neuraxial lesions.
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A G1P0 woman with aortic coarctation and mitral valve stenosis underwent endovascular aortic repair with continuous fetal monitoring during the 20th week of pregnancy. On tracheal extubation, an episode of fetal asystole followed by fetal bradycardia was identified. Ephedrine, nitroglycerin, and terbutaline were administered for intrauterine fetal resuscitation. ⋯ The fetal heart rate normalized. We conclude that intraoperative monitoring of a previable fetus may aid in optimizing maternal hemodynamics. Before performing interventional procedures in pregnant women, a multidisciplinary team should discuss the goals of neonatal care should adverse fetal events be detected.
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Radiofrequency (RF) scanning is an increasingly popular method of detecting retained surgical items. RF systems are generally regarded as safe but have the potential to cause electrical interference with pacemakers. ⋯ We present a case of an RF system used with a temporary pacemaker resulting in asystole. With the use of RF devices becoming widespread, it is important for all operating room personnel to recognize the potential for pacemaker interference from RF scanning devices and the requirements for asynchronous pacing when these devices are in use.