Personalized care of a rare complex case of Klippel Feil syndrome and Gestational Diabetes at a District hospital.

Klippel Feil syndrome is a rare inherited autosomal dominant condition associated with various anomalies. In this case report we present a successful management of a 33 years old pregnant patient with Klippel Feil syndrome and gestational diabetes, highlighting the various anomalies with Klippel Feil syndrome. Patient had previous 9 pregnancy losses including set of twins. She had undergone open Myomectomy on a Unicorn ate uterus and Laparoscopic abdominal cerclage. She had successful IVF.Her Gestational Diabetes was managed with Insulin in a multidisciplinary team specialist clinic. Fetus was in Breech presentation antenatal and transverse lie at Caesarean section The combination of KFS, the complex obstetrical history, the gestational diabetes and the difficult airway management during elective Caesarean section in this case presents an interesting clinical scenario for obstetricians and anesthesiologists. Conclusion: We manage this patient as follows A. The early detection and the proper management of gestational diabetes. B. In the above case the screening for GDM was done early at 16 weeks of gestation instead of 24-28 weeks due to high risk factors. The early detection and treatment of GDM play a vital role in the prevention of short- and long-term complications that affect the mothers and their babies.However, the current clinical practice of GDM diagnosis based on OGTT between 24-28 weeks which may not be early enough to prevent the consequences of GDM.C. The proper preoperative planning and multi-disciplinary team discussion prior surgery which helped to ensure satisfactory anesthesia during the surgery. D. Postnatal follow up to detect and treat T2DM which is a recognized long-term complication in GDM patient.


Dr Biza Akbar

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