Peripartum Anesthetic Management of Patient with Osteogenesis Imperfecta: Case Report and Literature Review

Abstract

Osteogenesis Imperfect (OI) (Brittle Bones Disease) is the most common hereditary connective tissue disease. The main clinical forms of OI are quantitative and qualitative anomalies of type I collagen, the most common protein in bones [8]. In modern literature, cases of successful delivery of patients with imperfect osteogenesis are described, however this disease is considered a contraindication to pregnancy, and when it is advised, an artificial interruption is recommended. Such tactic is associated with the occurrence of a significant number of complications, during pregnancy and delivery, sometimes fatal for both the mother and the fetus [8]. Caesarean section is conducted more often in such patients due to maternal pelvic deformity, cephalopelvic disproportion, abnormal fetal position variants [1,8]. In literature, there are few cases of an anesthetic aid for Cesarean Section (CS) in patients with OI (types 3-4). The clinical observation that is presented, describes features of labor management of a patient with OI type IV.