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Year : 2021  |  Volume : 15  |  Issue : 1  |  Page : 146-148

Peripartum management of gitelman syndrome for vaginal delivery: A case report and review of literature

1 Department of Anaesthesiology and Pain Medicine, “Elena Venizelou” General Hospital of Athens, Athens, Greece
2 Department of Obstetrics/Gynecology, “Elena Venizelou” General Hospital of Athens, Athens, Greece

Correspondence Address:
Dr. Konstantina Kalopita
Department of Anaesthesiology and Pain Medicine, “Helena Venizelou” General Hospital, 2 Helena Venizelou Square, GR 11521, Athens
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aer.aer_82_21

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We describe the anesthetic management of a spontaneous vaginal delivery at 38 weeks' gestation in a 36-year-old patient with Gitelman syndrome (GS). GS is a rare autosomal recessive renal tubulopathy characterized by hypomagnesemia, hypocalciuria, and secondary aldosteronism, which results in hypokalemia and metabolic alkalosis. To minimize any increase in catecholamine levels and consequent risk of ventricular arrhythmias, a labor epidural analgesia was administered using ropivacaine and fentanyl, along with intravenous magnesium and potassium supplementation. Ropivacaine was substituted for routine bupivacaine to decrease the risk of drug-induced cardiotoxicity. In the event of a cesarean section, the anesthetic plan was to continue with top-up epidural anesthesia and in case of failure, to convert to general anesthesia using propofol and rocuronium for induction. Delivery outcome was successful and uneventful.

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