Anesthetic management of maternal with rare Myositis ossificans disease undergoing emergency surgery for postpartum hemorrhage

  • Mohamad Azlan Awang
  • Mohd Firdaus bin Mohd Yusof
Keywords: Airway management, Awake fiberoptic intubation, Intubation, Myositis ossificans, Parturient, Postpartum hemorrhage

Abstract

Myositis ossificans (MO) is a rare disease which involve calcification of the pterygoid muscles leading to severe trismus and limited mouth opening, that is considered as difficult airway when proceeding with general anesthesia (GA). We report a case of 26-year-old parturient with an underlying MO of the pterygoid muscles, who developed postpartum hemorrhage due to retained placenta, and needed emergency manual removal of the placenta in the operating room. Providing anesthesia for these patients can present a significant challenge. Difficulty arises related to combination of airway management for GA, resuscitation and a narrow time window to commence to the surgery. Awake fiberoptic intubation is a safe method to secure the airway for such patient while multidisciplinary team effort of focused planning and resuscitation is crucial to avoid maternal morbidity and airway catastrophe.

Abbreviations: MO - Myositis Ossificans; GA - General Anesthesia; PPH - Postpartum Hemorrhage; TCI – Target Controlled Infusion

Key words: Airway management; Awake fiberoptic intubation; Intubation; Myositis ossificans; Parturient; Postpartum hemorrhage

Citation: Awang MA, bin Mohd Yusof MF. Anesthetic management of a parturient with myositis ossificans undergoing emergency surgery for postpartum hemorrhage. Anaesth. pain intensive care 2022;27(2):266−268; DOI: 10.35975/apic.v27i2.1977

Received: August 19, 2022; Reviewed: January 25, 2023; Accepted: January 31, 2023

Author Biographies

Mohamad Azlan Awang

Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah

Mohd Firdaus bin Mohd Yusof

Department of Anaesthesiology and Intensive Care, Hospital Sultanah Nur Zahirah, 20400 Kuala Terengganu

Published
04-05-2023
How to Cite
Awang, M., & Mohd Yusof, M. F. (2023). Anesthetic management of maternal with rare Myositis ossificans disease undergoing emergency surgery for postpartum hemorrhage. Anaesthesia, Pain & Intensive Care, 27(2), 266-268. https://doi.org/10.35975/apic.v27i2.1977
Section
Case Reports

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