Neuraxial anesthesia for labor and delivery in a parturient with unstable cervical spine fracture.

We report the successful anesthetic management of labor and passive second-stage delivery in a parturient requiring cervical spine stabilization with a halo. A 25-year-old, Gravida 1, Para 0 at 37 weeks of gestation, admitted for observation after a recent motor vehicle collision, required induction of labor for preeclampsia. The mode of delivery was dependent on a successful anesthetic technique for a passive second stage of labor. The injury and halo presented concerns for access to her airway and preservation of neurologic status. An epidural placed early in labor allowed for adequate analgesia, as well as sacral extension for a forceps-assisted delivery.