Pregnancy associated with kyphoscoliosis

Kim, Dae Ho; Lee, Jung Ryeol; Wang, Soo Kwan; Ko, Eun Mi; Shim, Soon Sup; Han, Soo Youn; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun; Syn, Hee Chul

Abstract

OBJECTIVE
To assess the outcomes of pregnancies in women with kyphoscoliosis. METHOD: A total of 15 patients (17 pregnancies) complicated by kyphoscoliosis were reviewed among 19,717 deliveries between Jan. 1991 and Apr. 2001, from the Department of Obstetrics and Gynecology, Seoul National University Hospital. Their prenatal course, mode of deliveries, and pregnancy outcomes were scrutinizingly investigated.
RESULTS
The incidence of kyphoscoliosis in this study was one per 1160 deliveries. The mean age of these patients in their pregnancies was 30.6+/-4.4 years (range 23-38), mean height 143.5+/-14.0 cm (range 124-160), and mean weight 55.8+/-14.4 kg (range 38-96). The causes of kyphoscoliosis included idiopathic (n=8), spinal tuberculosis (n=3), external trauma (n=3), poliomyelitis (n=1), spinal muscular atrophy (n=1), and progressive muscular dystrophy (n=1). The mean forced vital capacity (FVC) was 2.098+/-0.774 L (range 0.54-3.59) and mean vital capacity (VC) % predicted was 68.2+/-20.6% (range 24-105) prior to delivery. Vaginal delivery was performed in 4 cases, and cesarean section in 13. Fetal growth restriction was identified in 7 cases, and one case had both fetal heart anomaly and imperforate anus. Two babies were managed in neonatal intensive care unit; preterm birth at 34 weeks in one case, and term birth with low apgar score in the other. Maternal pulmonary complication was developed in two cases, the lowest two values of FVC and VC % predicted, one was FVC 0.86 L, VC % predicted 33% and the other was FVC 0.54L, VC % predicted 24%. These mothers were managed with transnasal oxygen therapy in one, artificial oxygen therapy in the other.
CONCLUSION
The maternal and perinatal risks in pregnancy associated with kyphoscoliosis may be dependent on maternal pulmonary function prior to delivery.