RESUMEN
Pudendal nerve block may be indicated during instrumental delivery in situations where peridural anesthesia is unavailable. We report three cases of neonatal lidocaine intoxication following maternal pudendal block during delivery. Clinical features were hypotonia, pupillary mydriasis fixed to light, apnea, cyanosis and seizures. Two neonates required mechanical ventilation. Lidocaine was found in the serum of two babies. In all three cases, recovery was complete. The pharmacokinetics of lidocaine in a highly vascularized perineum during labor increase the risk of neonatal intoxication. A possible intoxication by local anesthetics should be considered in neonates presenting an acute distress in the delivery room.
Asunto(s)
Anestesia Obstétrica/efectos adversos , Anestésicos Locales/efectos adversos , Lidocaína/efectos adversos , Anestésicos Locales/sangre , Apnea/inducido químicamente , Femenino , Humanos , Recién Nacido , Lidocaína/sangre , Masculino , Intercambio Materno-Fetal , Hipotonía Muscular/inducido químicamente , Midriasis/inducido químicamente , Bloqueo Nervioso , Embarazo , Convulsiones/inducido químicamenteRESUMEN
We report on a case of familial congenital scalp defect with fetal bleeding during labor. The authors emphasize the frequency of familial forms and the potential risk of such abnormalities during labor's monitoring. Treatment and classification are reviewed. The prognosis is good, as shown by the mother's case 27 years later.
Asunto(s)
Hemorragia/etiología , Cuero Cabelludo/anomalías , Anomalías Cutáneas , Femenino , Humanos , Recién NacidoRESUMEN
A case of Moebius syndrome in a premature baby is reported. After a phase of neonatal severe respiratory distress syndrome, the baby presented with a persistent facial paralysis, already present at birth and inability to close the eyes (also present in her father), without ophthalmoplegia. An unusual pharyngeal and laryngeal paralysis was also present: it led to tracheal intubation then tracheostomy and gastrostomy. CT scan at 15 months of age showed hypoplasia of brain stem. The difficulties of managing bulbar paralysis in such a premature baby are emphasized.