516 posters, 59 topics, 63 sessions, 1,127 authors, 353 institutions
ePostersLive by SciGen Technologies S.A. All rights reserved.
2026 SOAP Annual Meeting
April 29 - May 3, 2026 | Montreal, Quebec Canada
2339441
Challenges during labor anesthesia in a patient with Klippel-Trenaunay syndrome
Poster Presenter
Authors
Affiliations
Part of Topic
STRANGE CONDITIONS
-
Klippel-Trenaunay (KT) syndrome: manifests as capillary, venous, and lymphaticmalformations predominantly affecting a single lower extremity.
-
Presents as cutaneous port-wine stains, (90-100%); venous (varicosities,aplasia/hypoplasia, valvular incompetence, [70-100%]); and lymphatic (lymphedema[15-50%]).1,2
-
Patients with KT syndrome present challenges for the obstetric anesthesiologist due tovascular malformations surrounding the spinal cord, vascular malformations within thepelvis increasing risk of post-partum hemorrhage, and risk of thrombus formation andembolus due to physiologic changes of pregnancy causing venous distension and stasis.
-
In this case, we highlight the management of a parturient with KT syndrome withoutcomplete workup.
-
29-y-o G1P0 @39 wks 4 d in latent labor.
-
KT syndrome affecting primarily the left lower extremity (varicose veins s/p failedsclerotherapy & separate surgical excisions). Now minimally symptomatic, no significantmanifestations of the syndrome.
-
MFM advised on prophylactic LMWH -> heparin at 37 wks. MRI brain thoracic spinal cord (toL2), BUT NOT lumbar spine obtained revealing no vascular malformations. of the visualizedanatomy. The thoracic spine imaging only visualized as low as L1-L2. Anticoagulation held>12 hours prior to presentation.
-
After discussion of risks, opted for neuraxial analgesia. Epidural placed at L1-L2 withoutcomplication and maintained with Bupi 0.0625%/fent 2mcg/mL at 10 mL/hr with no top offs.
-
NSVD 7 hours later. Methylergonovine & misoprostol given due to brisk bleeding noteddespite good uterine tone. QBL 550mL. LMWH restarted following epidural catheter removal,and the patient was discharged 36 hours after delivery.
-
Despite no consensus for the anesthetic management of parturients with KTsyndrome, case reports describe the management of these patients.3,4
-
Workup includes:
-
MRI abdomen/pelvis to exclude vascular malformations
-
MRI of the brain/spine to assess safety of neuraxial anesthesia
-
prophylactic anticoagulation.
-
MFM, hematology, and obstetric anesthesia involvement guideworkup and management.
-
-