Regional Anesthesia Challenges in a Pregnant Patient with VACTERL Association: A Case Report
Article Sidebar
Main Article Content
Abstract
VACTERL (V: Vertebral anomalies, A: Anal malformation, C: Cardiac defect, TE: Tracheoesophageal malformation, R: Renal anomalies, L: Limb anomalies) is a cluster of congenital malformations. It is a rare association with sporadic and non-random occurrence where multiple organs are affected due to developmental defect during blastogenesis (2-4 weeks of gestation), where abnormal structures are derived from the embryonic mesoderm. Multiple environmental and genetic factors have been implicated. We report the successful management of a patient with VACTERL association born to a mother through an emergency cesarean section due to fetal distress.
Article Details
Copyright (c) 2025 Khanam U, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Velazquez D, Pereira E, Havranek T. Neonate with VACTERL association and a branchial arch anomaly without hydrocephalus. AJP Rep. 2016;6(1):74-6. Available from: https://doi.org/10.1055/s-0035-1566297
Bhagat M. VACTERL association-type anomalies in a male neonate with a Y-chromosome abnormality. OMCR. 2015;2015:164-166. Available from: https://doi.org/10.1093/omcr/omu062
Ramosa JA, Shashank S, Shettarb SS, James CF. Neuraxial analgesia in a parturient with the VACTERL association undergoing labour and vaginal delivery. Rev Bras Anaesthesiol. 2016;343-9.
Quan L, Smith DW. The VATER association. Vertebral defects, anal atresia, T-E fistula with oesophageal atresia, radial and renal dysplasia: a spectrum of associated defects. J Pediatr. 1973;82:104–107. Available from: https://doi.org/10.1016/s0022-3476(73)80024-1
Solomon BD. VACTERL/VATER association. Orphanet J Rare Dis. 2011;6:56. Available from: https://doi.org/10.1186/1750-1172-6-56
Hersh JH, Angle B, Fox TL, Barth RF, Bendon RW, Gowans G. Developmental field defects coming together of associations and sequences during blastogenesis. Am J Med Genet. 2002;110:320-3. Available from: https://doi.org/10.1002/ajmg.10429
Shaw-Smith C. Genetic factors in oesophageal atresia, tracheo-oesophageal fistula and the VACTERL association: Roles for FOXF1 and the 16q24.1 FOX transcription factor gene cluster, and review of the literature. Eur J Med Genet. 2010;53(1):6-13. Available from: https://doi.org/10.1016/j.ejmg.2009.10.001
Chen Y, Liu Z, Chen J, Zuo Y, Liu S, Chen W, et al. The genetic landscape and clinical implications of vertebral anomalies in VACTERL association. J Med Genet. 2016;53:431-7. Available from: https://doi.org/10.1136/jmedgenet-2015-103554
Czeizel A, Ludanyi I. An aetiological study of the VACTERL-association. Eur J Pediatr. 1985;144:331-7. Available from: https://doi.org/10.1007/bf00441773
Cevik MO, Celik M, Bucak IH, Almis BH, Turgut M. Possible relation of antenatal venlafaxine use and VACTERL association in a newborn: A case report. Turkish J Psychiatr. 2017;28(1):67-70. Available from: https://pubmed.ncbi.nlm.nih.gov/28291300/
Bjørsum-Meyer T, Herlin M, Qvist N, Petersen MB. Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/oesophageal atresia, renal defect, and limb defect association with Mayer-Rokitansky-Küster-Hauser syndrome in co-occurrence: two case reports and a review of the literature. J Med Case Rep. 2016;10(1):374. Available from: https://doi.org/10.1186/s13256-016-1127-9
Lawhon SM, MacEwen GD, Bunnell WP. Orthopaedic aspects of the VATER association. J Bone Joint Surg Am. 1986;68:424-9. Available from: https://pubmed.ncbi.nlm.nih.gov/3949837/
Raam MS, Pineda-Alvarez DE, Hadley DW, Solomon BD. Long-term outcomes of adults with features of VACTERL association. Eur J Med Genet. 2011;54:34-41. Available from: https://doi.org/10.1016/j.ejmg.2010.09.007
Reddy AKV, Soren C. VACTERL association in a newborn - A rare case report. IOSR J Dental Med Sci. 2017;16(1):31-3. Available from: https://www.iosrjournals.org/iosr-jdms/papers/Vol16-issue1/Version-5/F1601053133.pdf
Botto LD, Khoury MJ, Mastroiacovo P, Castilla EE, Moore CA, Skjaerven R, et al. The spectrum of congenital anomalies of the VATER association: an international study. Am J Med Genet. 1997;71:8-15. Available from: https://pubmed.ncbi.nlm.nih.gov/9215761/
Hara T, Nakajima M, Sugano H, Karagiozov K, Miyajima M, Arai H. Cerebrospinal fluid over-drainage associated with upper cervical myelopathy: successful treatment using a gravitational add-on valve in two cases. Interdiscip Neurosurg. 2020;19:100586. Available from: https://doi.org/10.1016/j.inat.2019.100586