Peripartum Anesthetic Management In A Patient With Klippel Trenaunay Syndrome

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Medically Challenging Case Report Poster 


Danielle Zheng  
Mayo Clinic


David Olsen  
Mayo Clinic
Emily Sharpe  
Mayo Clinic


Klippel-Trenaunay syndrome (KTS) is a rare congenital disease of venous malformations. A 34 year old G1P0 with KTS had induction of labor at 39 weeks. Skin pigmentation was noted in the abdomen. MRI revealed no venous malformation involving the uterus, vagina, or tissues of the lumbar spine. Coagulation testing was normal; increased risk of bleeding was discussed. A combined spinal-epidural was placed for labor analgesia. She underwent Cesarean delivery under epidural anesthesia for arrest of descent, converted to general anesthesia for pain, and delivered a healthy infant with blood loss of 1200mL. KTS is associated with increased risk of hemorrhage and coagulopathy. Spine imaging is recommended prior to neuraxial anesthesia placement.

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Enter up to two references.

1. Chadha R. Management of Pregnancy with Klippel-Trenaunay-Weber Syndrome: A Case Report and Review. Case Rep Obstet Gynecol. 2018 July 12, Article ID 6583562.
2. Keepanasseril A, et al. Pregnancy in women with Klippel-Trenaunay syndrome: Report of three pregnancies in a single patient and review of literature. Obstet Med. 2017 Dec; 10(4): 177-182.