Neuraxial Anesthesia in a Parturient With Newly Diagnosed Klippel-Trenaunay Syndrome: A Case Report

TL;DR

This case report describes the safe use of neuraxial anesthesia in a pregnant woman with Klippel-Trenaunay syndrome during an emergency cesarean section.

Contribution

The paper presents a rare and successful clinical case of neuraxial anesthesia in a patient with KTS and no prior imaging.

Findings

Neuraxial anesthesia was safely administered without complications in a parturient with KTS.

Careful risk assessment was critical due to the absence of imaging and potential for difficult airway or neuraxial hematoma.

Abstract

Klippel-Trenaunay syndrome (KTS) is a complex, congenital vascular disorder characterized by three primary manifestations: cutaneous capillary malformation (most commonly port-wine stain), congenital varicose veins, and soft tissue and bone hypertrophy. In the obstetric population, the evaluation of these vascular malformations is essential to mitigate bleeding risk with regional, neuraxial, and general anesthesia, particularly if there is the involvement of the spinal column or oropharyngeal airway. We report a unique case highlighting the successful administration of neuraxial anesthesia in a parturient with KTS undergoing an emergent cesarean section for fetal deterioration. In the absence of available imaging, careful consideration was given to balance the risks of neuraxial hematoma and a potentially difficult airway.