Anesthetic Challenges in a Parturient with Klippel-Feil Syndrome Scheduled for Elective Lower Segment Cesarean Section

Klippel–Feil syndrome (KFS) is a congenital anomaly characterized by cervical spine fusion, restricted neck movement, and other systemic abnormalities, posing significant challenges during perioperative management. We present the case of a 29-year-old primigravida with KFS scheduled for elective lower segment cesarean section (LSCS) at 38 weeks of gestation. Our patient exhibited classical features of KFS with bilateral sensorineural hearing loss leading to mutism, hypothyroidism, ventricular septal defect, and thoracic scoliosis. Considering the risks associated with general anesthesia compounded by pregnancy-related airway changes, combined spinal and epidural anesthesia was planned. Awake fiber-optic intubation was kept as a backup plan. The surgery was uneventful and the patient recovered without any complications. This case underscores the importance of a multidisciplinary approach, detailed preoperative evaluation, and tailored anesthetic planning to address the complex challenges in parturient with KFS, ensuring optimal perioperative outcomes.