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Published on: November 21, 2017
Malignant Hyperthermia in Obstetric Anesthesia
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 8-120, Baltimore, MD 21287, USA.
Abstract:
Malignant hyperthermia (MH) is a pharmacogenetic disorder characterized by a life-threatening hypermetabolic response to volatile anesthetic agents and depolarizing muscle relaxants in susceptible individuals. Although rare, MH poses unique challenges in the obstetric population, where physiologic adaptations of pregnancy may obscure early clinical signs and where both maternal and fetal outcomes are at stake. This article reviews the epidemiology, pathophysiology, clinical presentation, and management of MH in the obstetric setting. Emphasis is placed on preoperative identification of susceptible patients, safe anesthetic techniques for labor and delivery, and the multidisciplinary approach to both prevention and acute crisis management.
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