Balancing Risks in Obstetrics: Anesthesia Management in Facioscapulohumeral Muscular Dystrophy with Scoliosis

Abstract

Facioscapulohumeral muscular dystrophy (FSHD), the third most common form of muscular dystrophy, is associated with a normal life expectancy, resulting in more pregnant women presenting with the condition. Pregnancy often exacerbates muscle weakness in patients with FSHD, posing unique perioperative challenges. Careful evaluation of systemic involvement is essential to minimize maternal and neonatal risks. Perioperative management is often challenging because both general and neuraxial anesthesia carry significant risks. Spinal deformities further complicate anesthesia management, requiring troubleshooting. Apart from these challenges, literature on managing FSHD during cesarean sections is limited. We report the successful anesthetic management of an elective cesarean section in a patient with FSHD and scoliosis, reviewing troubleshooting measures for neuraxial blocks in spinal deformities.

Keywords: facioscapulohumeral muscular dystrophy; genetics; obstetric anesthesia; spine deformities.