Anesthetic Management of a Parturient with Thalidomide Phocomelia

Samuel N. Blacker, Tiffany E. Angelo

Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, USA..
Department of Anesthesiology, Womack Army Medical Center, Fort Bragg, NC, USA.

DOI: 10.4236/ojanes.2012.23014                

Abstract

The teratogenicity of thalidomide has been known since the early 1960s [1]. Thalidomide is currently used world wide, including the United States, to treat erythema nodosum leprosum, multiple myeloma, refractory Crohn’s disease, aphthous stomatitis and HIV wasting syndrome. New cases of thalidomide phocomelia are being reported as well. We report a case of the anesthetic challenges of a 23 year-old parturient with thalidomide phocomelia and review the important anesthetic challenges it presents. Spontaneous vaginal delivery under continuous lumbar epidural was achieved in this challenging patient. However, it required careful planning for reliable intravenous access and the use of magnetic resonance imaging (MRI) of her pelvis and lumbar spine.

Keywords

Anesthesia; Thalidomide Phocomelia; Obstertric Anesthesia

Conflicts of Interest

The authors declare no conflicts of interest.

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