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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

GUZMAN-LOPEZ, Abel et al. Clinical treatment and outcome of a patient with arthrogryposis multiplex congenita. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.4, pp.253-256.  Epub May 07, 2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v87i4.2847.

BACKGROUND:

Arthrogryposis multiplex congenita is a rare entity characterized by the appearance of multiple muscle contractures in various parts of the body. Pregnant patients with this condition have a higher risk of complications in obstetric management.

CLINICAL CASE:

A 19-year-old patient, with arthrogryposis multiplex congenita, eight weeks pregnant, attended in medical service to start prenatal care. Received advice on the cardiovascular and respiratory system risks, secondary to the underlying disease, that could be exacerbated by pregnancy. The ultrasound during the 22nd week of pregnancy did not report any structural alterations. The patient continued in prenatal control, without respiratory difficulty or cardiovascular alterations. Did not receive prophylactic anticoagulants, neither showed signs of thrombosis. We decide finished the pregnancy by caesarean section, due to the limited movement of the hip. Surgery was scheduled at week 38.3 of pregnancy, with assessment by the Cardiology service, who reported adequate left ventricular ejection fraction and no evidence of cardiomyopathy. Epidural anesthesia was applied without complications. The physical examination of the newborn showed no alterations. Currently, the mother and her son remain in good health.

CONCLUSIONS:

In pregnant patients with arthrogryposis multiplex congenita its important to explain the inherent risks of their condition and their possible complications. Multidisciplinary management should be performed with cardiovascular, respiratory, and serial reviews to ensure the welfare of the maternal-fetal binomial.

Keywords : Pregnancy; Arthrogryposis multiplex congenita; Caesarean section; Epidural block anesthesia.

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