Advertisement
Review article| Volume 4, ISSUE 4, P244-247, October 1995

Anesthetic management of the parturient with ankylosing spondylitis

  • R.A. Bourlier
    Affiliations
    Departments of Anesthesiology and Obstetrics and Gynecology, St. Luke's Roosevelt Hospital Center, College of Physicians and Surgeons of Columbia University, New York, USA
    Search for articles by this author
  • D.J. Birnbach
    Correspondence
    Correspondence to D. J. Birnbach MD, Director of Obstetric Anesthesiology, St Luke's-Roosevelt Hospital Center, 1000 Tenth Avenue, New York, New York 10019, USA.
    Affiliations
    Departments of Anesthesiology and Obstetrics and Gynecology, St. Luke's Roosevelt Hospital Center, College of Physicians and Surgeons of Columbia University, New York, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Summary

      Pregnancy may occur in patients with ankylosing spondylitis, a chronic inflammatory joint disease. This disease, which is included in the group of seronegative spondylarthropathies, may be characterized by both intra- and extra-articular manifestations. Although most pregnant patients with ankylosing spondylitis experience normal spontaneous vaginal deliveries, manifestations of the disease may interfere with labor and delivery as well as the administration of general and regional anesthesia. Therefore, physicians caring for a pregnant patient with ankylosing spondylitis should be aware of the obstetric and anesthetic implications and the ramifications of active disease. These patients should be referred to an anesthesiologist early in pregnancy so that the obstetrician and anesthesiologist can together formulate a plan.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Obstetric Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hart FD
        • Bell AC
        • Organe GS
        Pregnancy in ankylosing spondylitis: a report of two cases.
        Ann Rheum Dis. 1951; 10: 54-60
        • Wolheim FA
        Ankylosing Spondylitis.
        in: Kelley WN Harris Ruddy S Hedge CB Textbook of Rheumatology. WB Saunders, Chicago1993: 943-960
        • Ball J
        Enthesopathy of rheumatoid and ankylosing spondylitis.
        Ann Rheum Dis. 1971; 30: 213-223
        • Gran JT
        • Husby G
        Ankylosing spondylitis in women.
        Semin Arthritis Rheum. 1990; 19: 303-312
        • Rigby AS
        Review of UK data on the rheumatic diseases-5 ankylosing spondylitis.
        Br J Rheumato. 1991; 30: 50-53
        • Gran JT
        • Husby G
        The epidemiology of ankylosing spondylitis.
        Semin Arthritis Rheum. 1993; 22: 319-334
        • Graham W
        • Huchida IA
        Heredity in ankylosing spondylitis.
        Ann Rheum Dis. 1957; 16: 334-339
        • Brewerton DA
        • Hart FD
        • Nicholls A
        • et al.
        Ankylosing spondylitis and HL-A 27.
        Lancet. 1973; 1: 904-907
        • Schlosstein L
        • Terasaki PI
        • Bluestone R
        • et al.
        High association of an HL-A antigen, W27, with ankylosing spondylitis.
        N Engl J Med. 1973; 288: 704-706
        • Carter ET
        • McKenna CH
        • Brian DD
        • Kurland LT
        Epidemiology of ankylosing spondylitis in Rochester, Minnesota 1935–1973.
        Arthritis Rheum. 1979; 22: 365-370
        • Østensen M
        • Romberg Ø
        • Husby G
        Ankylosing spondylitis and motherhood.
        Arthritis Rheum. 1982; 25: 140-143
        • Østensen M
        • Husby G
        A prospective clinical study of the effect of pregnancy on rheumatoid arthritis and ankylosing spondylitis.
        Arthritis Rheum. 1983; 26: 1155-1159
        • Østensen M
        • Husby G
        Ankylosing spondylitis and pregnancy.
        Rheum Dis Clin North Am. 1989; 15: 241-254
        • Kupperman HG
        • Bartfeld H
        Rheumatoid spondylitis treated with cortisone.
        NY State J Med. 1952; 52: 1157-1159
        • Tucker CR
        • Fowles RE
        • Calin A
        • Poppe RL
        Aortitis in ankylosing spondylitis: early detection of aortic root abnormalities with two-dimensional echocardiography.
        Am J Cardiol. 1982; 49: 680-686
        • Cheek TG
        • Gutsche BB
        Maternal physiologic alterations during pregnancy.
        in: Shnider SM Levinson G Anesthesia for obstetrics. Williams & Wilkins, Philadelphia1993: 3-17
        • Pirlo AF
        • Herren AL
        Ankylosing spondylitis.
        in: Case report and review of literature. Anesthesiol Rev. 5. 1978: 13-16
        • Sinclair JR
        • Mason RA
        Ankylosing spondylitis.
        in: The case for awake intubation. Anaesthesia. 39. 1984: 3-11
        • Hauch MA
        • Bromley B
        Autoimmune diseases.
        in: Datta S Anesthetic and obstetric management of high-risk pregnancy. Mosby Year Book, Philadelphia1991: 394-396
        • Franssen MJ
        • van Herwaarden CL
        • van de Putte LB
        • Gribnau FW
        Lung function in patients with ankylosing spondylitis.
        in: A study of the influence of disease activity and treatment with non-steroidal anti-inflammatory drugs. J Rheumatol. 13. 1986: 936-940
        • Travis DM
        • Cook CD
        • Julian DG
        • et al.
        The lungs in rheumatoid spondylitis.
        in: Gas exchange and lung mechanics in a form of restrictive pulmonary disease. Am J Med. 29. 1960: 623-632
        • Eisele JH
        Connective tissue diseases.
        in: Katz J Benumof JL Kadis L Anesthesia and uncommon diseases. WB Saunders Company, St Louis1990: 645-667
        • Thomas DJ
        • Kendall MJ
        • Whitfield AG
        Nervous system involvement in ankylosing spondylitis.
        BMJ. 1974; 1: 148-150
        • Tullous MW
        • Skerhut HE
        • Story JL
        Cauda equina syndrome of long-standing ankylosing spondylitis.
        in: Case report and review of the literature. J Neurosurg. 73. 1990: 441-447
        • Mitchell MJ
        • Sartoris DJ
        • Moody D
        • Resnick D
        Cauda equina syndrome complicating ankylosing spondylitis.
        Radiology. 1990; 175: 521-525
        • Mallampati SR
        • Gatt SP
        • Gugino LD
        • et al.
        A clinical sign to predict difficult intubation: a prospective study.
        Can Anaesth Soc J. 1985; 32: 429-434