We describe the management of a pregnant patient with osteogenesis imperfecta with a history of numerous fractures, severe scoliosis, and anticipated difficult airway. Her pregnancy was complicated by progressive shortness of breath and a fetal diagnosis of osteogenesis imperfecta. Spine anatomy precluded neuraxial anesthesia. Cesarean delivery was performed under general anesthesia at 34 weeks. Immediately after awake fiberoptic intubation and induction of general anesthesia, capnography waveform was lost with rapid profound oxygen desaturation. A supraglottic airway device was placed, oxygenation maintained with supraglottic airway and positive pressure ventilation throughout case, and the baby was delivered with Apgars of 8 and 9.
From the *Department of Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Houston, Texas
†Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California.
Accepted for publication December 7, 2018.
The authors declare no conflicts of interest.
Address correspondence to Caitlin Dooley Sutton, MD, Department of Pediatric Anesthesia, Perioperative, and Pain Medicine, Texas Children’s Hospital, 6621 Fannin St, Suite A3300, Houston, TX 77030. Address e-mail to firstname.lastname@example.org.