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    SPINAL ANESTHESIA IN PARTURIENT WITH SEVERELY SCOLIOTIC SPINE
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2018-12)
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    Ivanov, Emilija
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    Veninov, Filip
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    Spasovski, Sasho
    The choice of anesthesia in parturients with severe scoliosis undergoing an elective cesarean section (C-section) is associated with potential risks for both mother and fetus and presents a challenge for the anesthesiologist when considering the type of anesthesia that should be used. Alterations in the maternal physiology and potential perioperative complications associated with this comorbidity can cause difficulties when both general and spinal anesthesia are used. After reviewing all risk factors associated with both types of anesthesia, we consider that a single shot spinal anesthesia can be a successful type of anesthesia in severely scoliotic individuals, especially in those with pulmonary compromise. Here we present a successful case of parturient undergoing а spinal anesthesia for C-section performed at the University Hospital for Genecology in Skopje.
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    ANESTHETIC MANAGEMENT FOR PATIENT WITH TRACHER COLLINS SYNDROME SCHEDULED FOR ELECTIVE CESAREAN DELIVERY
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2018-12)
    Zlatkova, Milica
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    Ivanov, Emilija
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    Popovska, Rusanka
    Tracher Collins Syndrome is an autosomal dominant genetic disorder, as a result from mutation in TCOF1 gene. Other names for Treacher Collins Syndrome include Franceschetti- Zwalen-Klein syndrome, mandibulofacial dysostosis (MFD), zygo-auro-mandibular dysplasia and Treacher Collins Franceschetti syndrome. These changes cause deformities of the facial bones and occurrence at antimongoloid slant of the eyes, micrognathia and deformity of the ears. Complications may include breathing problems, seeing problems, cleft palate and hearing lost. Diagnosis of TCS is made through clinical evaluation, radiographic examination and molecular genetic analysis. Treatment is tailored to the specific needs of each individual by a multidisci- plinary craniofacial management team. We report a case of TCS with second twin pregnancy achieved with IVF. The first pregnancy ended with c-section (and death of the newborn after 23 days of delivery due to dysmorphia – TCS on the fetus). The patient was hospitalized at our clinic for evaluation and ending of pregnancy with elective section cesarean. The patient was managed successfully under regional anesthesia which is generally preferred technique to general anesthesia, in order to avoid potential complications associated to difficult airway management. The patient was left home on the fifth postoperative day with her two healthy children.