Malignant hyperthermia (MH) is a potentially fatal disorder triggered by volatile anesthetics or succinylcholine, inducing a hypermetabolic crisis in susceptible patients. The caffeine-halothane contracture test (CHCT) remains a gold standard for MH detection. The authors describe a pregnant patient with a history of exertional rhabdomyolysis, who required urgent MH screening for administration of MH-triggering anesthetics. This anesthetic plan allowed for an in utero myelomeningocele repair for a 24-week-old fetus. A multi-institutional team coordinated the urgent CHCT and repair with a favorable outcome.
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