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Managing a Pregnancy With Maternal Amelia

Siwatch, Sujata, MD, MPH; Gainder, Shalini, MD; Prasad, Gurgunjakunta Ramabhadraraju Venkateshwara, MD; Jain, Vanita, MD; Rohilla, Meenakshi, MD; Kuberan, Aswini, MD

doi: 10.1097/AOG.0000000000003235
Contents: Medical Complications of Pregnancy: Case Report
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INTRODUCTION: Amelia, the complete absence of a limb, presents various management issues in pregnancy and delivery.

CASE: A woman with amelia of both lower limbs and flipper-like upper limb buds (phocomelia) presented in her first pregnancy at 19 weeks of gestation. Challenging issues encountered in the care of the patient included venous access, reliable blood pressure measurement, recommendations regarding mode of delivery, and preparation for caring for the child. The patient had abnormalities of the pelvis but an adequate midpelvis, so she was able to deliver vaginally without complication.

CONCLUSION: Careful planning to allow necessary modification of intrapartum management can allow for normal vaginal birth for a patient with severe limb reduction abnormalities such as amelia and phocomelia.

Modifications of routine perinatal care are necessary when caring for a pregnant woman with amelia.

Department of Obstetrics & Gynecology, PGIMER, Chandigarh, and the Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India.

Corresponding author: Sujata Siwatch, MD, MPH, Obstetrics & Gynecology, PGIMER, Sector-12, Chandigarh, India 160012; email: siwatch1@yahoo.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Mr. Dharamjit Singh, Senior Artist, PGIMER for drawing Figure 2 for the article.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews are available at http://links.lww.com/AOG/B330.

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.