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Case Report

Emergency Lower Segment Caesarean Section in a Patient with Neurofibromatosis: Anaesthetic Challenges and Management

Ravi Madhusudhana, Panguluri Bala Venkat, Mudigonda Sai Sharath Meghana, Devini Sneha Vijayalakshmi, Nataraja Jayakumar Siva Shankar

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Indian Journal of Anesthesia and Analgesia 13(4):p 217-219, October-December 2026. | DOI: https://doi.org/10.21088/ijaa.2349.8471.13426.10

How Cite This Article:

Panguluri Bala Venkat, Ravi Madhusudhana, Mudigonda Sai Sharath Meghana et. al, Emergency Lower Segment Caesarean Section in a Patient with Neurofibromatosis: Anaesthetic Challenges and Management. Ind J Anesth Analg. 2026; 13(4): 217-219.

Timeline

Received : August 31, 2026         Accepted : October 05, 2026          Published : December 30, 2026

Abstract

Neurofibromatosis (NF) especially Type 1, is a autosomal dominant disorder characterized by multiple neurofibromas, café-au-lait spots, and possible airway, spinal, and systemic involvement. These features pose significant anaesthetic challenges, particularly in emergency obstetric situations like LSCS. A 33 year old G2P1L1 with 37 weeks 2 days gestation with cephalic presentation with previous LSCS in active labour with known neurofibromatosis who underwent emergency lower segment caesarean section for foetal distress. The patient presented with multiple cutaneous neurofibromas and possible airway involvement, raising concerns regarding difficult airway and neuraxial anaesthesia safety. Preoperative evaluation was limited due to the emergency nature of the procedure. Airway assessment suggested potential difficulty, and spinal abnormalities could not be ruled out. Considering these factors, a carefully planned anaesthetic approach was undertaken. Regional anaesthesia was administered with caution after assessing the absence of obvious spinal deformities, and the procedure was successfully completed under subarachnoid block. Intraoperative and postoperative periods were uneventful, with stable maternal and fetal outcomes. Emergency LSCS in NF patients requires: Rapid assessment, Airway preparedness, Careful selection of anaesthetic technique. Spinal anaesthesia can be safely given in selected cases. Key Messages: Neurofibramatosis, Subarachnoid block.

References

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Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Panguluri Bala Venkat, Ravi Madhusudhana, Mudigonda Sai Sharath Meghana et. al, Emergency Lower Segment Caesarean Section in a Patient with Neurofibromatosis: Anaesthetic Challenges and Management. Ind J Anesth Analg. 2026; 13(4): 217-219.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
August 31, 2026 October 05, 2026 December 30, 2026
DOI: https://doi.org/10.21088/ijaa.2349.8471.13426.10

Keywords

NeurofibromatosisEmergency LSCSDifficult AirwayRegional AnaesthesiaObstetric Anaesthesia

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Timeline

Received August 31, 2026
Accepted October 05, 2026
Published December 30, 2026

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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