# Labor Analgesia in a Patient With Beals Syndrome: A Case Report of Management Challenges

## TL;DR

This case report details the successful use of labor analgesia in a woman with Beals syndrome, a rare connective tissue disorder.

## Contribution

The paper presents a rare case and outlines anesthetic strategies for managing labor in patients with Beals syndrome.

## Key findings

- A combined spinal/epidural technique was successfully used for labor analgesia.
- Lower-than-usual volumes of intermittent top-ups were sufficient during labor.
- The patient and baby had an uncomplicated delivery and were discharged three days later.

## Abstract

Beals syndrome, also known as Beals-Hetch syndrome or congenital contractural arachnodactyly, is an autosomal dominantly inherited, rare connective tissue disorder characterized by flexion contractures, arachnodactyly, camptodactyly, severe kyphoscoliosis, and, less frequently, cardiovascular features. We describe the successful management of labor analgesia in a pregnant woman with Beals syndrome. During labor, a combined spinal/epidural technique was performed uneventfully, and intermittent top-ups were administered as needed at lower-than-usual volumes. Eutocic delivery occurred without complications, and both mother and baby were discharged three days later. Given the sparse literature about obstetric patients with Beals syndrome, we summarize the main anesthetic challenges and suggested approaches.