Analgesic management of a parturient with cystic fibrosis
Abstract
Cystic fibrosis (CF) is an inherited autosomal recessive disorder appearing in approximately 1:2000 live births in the Caucasian population, responsible for early mortality in affected patients, often before they reach reproductive age. It was first described in the 1930s, and it was associated with a dismal prognosis. Improvements in the treatment of these patients have resulted in improved quality of life and longer life expectancy beyond sexual maturity. Since the first report of pregnancy in a patient with cystic fibrosis in 1960, the rates of conception have increased dramatically. Lung morbidity requires priority pain management during labor in order to reduce the burden imposed by pain on the cardiorespiratory system. Analgesia delivered over the epidural catheter reduces and eliminates pain, enhancing comfort and making a line available for regional anesthesia if required. This eliminates the need for orotracheal intubation and the deleterious effect on the weakened respiratory system.
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