Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery

Goldszmidt, Eric; Macarthur, Alison; Silversides, Candice; Colman, Jack M.; Sermer, Mathew; Siu, Samuel C.

doi:10.1016/j.ijoa.2009.09.006

Cited by 34 publications

(11 citation statements)

References 29 publications

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“…The presence of heart disease in pregnant women is of paramount importance for anesthetic management. Pregnant with cyanotic heart disease, cardiomyopathy, aortic and mitral valve stenosis, mechanic valve diseases, and pulmonary hypertension are the group under the highest-risk [10]. Management of these patients is challenging because rapidly changing heart rate, cardiac output, venous return, and vascular resistance especially in severe stenosis of mitral and aortic valves, and for this reason, a strict follow-up is crucial [11].…”

Section: Case Report Discussionmentioning

confidence: 99%

A Case of Unrecognized Peripartum Cardiomyopathy Which Was Noticed During Emergency Cesarean Section

Aslan

2018

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Peripartum cardiomyopathy (PPCMP) is a kind of dilated cardiomyopathy seen between the last week of gestation and the postpartum 5 th month. PPCMP may be a cause of mortality for the mother and the infant. PPCMP is associated with black race, multi parity, maternal age above 30 years, multiple pregnancy, preeclampsia, eclampsia, family history, obesity, smoking, diabetes mellitus, and hypertension, but the underlying cause is not clear [1]. In this case report, we present the diagnosis of peripartum cardiomyopathy, anesthetic management, and postoperative intensive care period in a patient who developed pulmonary edema during emergency cesarean operation. We aimed to underline that per partum cardiomyopathy should be remembered among the presumed diagnoses in case of acute pulmonary edema. Significances of Bioengineering & Biosciences C CRIMSON PUBLISHERSWings to the Research

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Section: Case Report Discussionmentioning

confidence: 99%

A Case of Unrecognized Peripartum Cardiomyopathy Which Was Noticed During Emergency Cesarean Section

Aslan

2018

SBB

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“…Moreover, hypotension, hypoxemia, hypercarbia, and hypothermia should be avoided during the surgery; otherwise the shunt may reverse (Eisenmenger syndrome) (3). Previous studies have indicated that regional anesthesia is the most common type of anesthesia (5,8). However, during the surgery, intracardiac shunt may reverse due to acute-onset, uncontrolled hypotension and hemodynamic instability (1).…”

Section: Discussionmentioning

confidence: 99%

Emergency Cesarean ın a Patıent Wıth Atrıal Septal Defect

Karaaslan¹

2017

Eastern J Med

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“…Hal inilah yang menjadi dasar anatomi terjadinya selektif analgesia setelah opioid intratekal diberikan. 15,16 Opioid intratekal secara selektif akan memblok transmisi stimulus dari serabut saraf А, δ dan С afferent nociceptive dengan membentuk ikatan pada reseptor opioid di Telah banyak penelitian yang membuktikan efektifitas penggunaan opioid pada anestesi spinal terutama pada operasi sesar. Penelitian-penelitian sebelumnya membuktikan bahwa opioid lipofilik contohnya fentanyl dapat mempercepat awitan dan memperpanjang durasi blok bupivakain serta memperpanjang durasi analgesia pascaoperasi.…”

Section: Pembahasanunclassified

Anestesia Spinal Dosis Rendah untuk Seksio Sesarea pada Pasien Mitral Stenosis Berat

Hidayat

Uyun

Bisri

2020

JAOI

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Penyakit jantung pada kehamilan meningkatkan angka morbiditas dan mortalitas ibu dan janin. Mitral stenosis adalah lesi katup jantung yang paling sering didapatkan pada wanita hamil dan hampir selalu disebabkan oleh penyakit jantung rematik. Perubahan fisiologis yang terjadi selama kehamilan dan periode peripartum dapat memperburuk gejala dan derajat penyakit jantung. Akibatnya, banyak wanita pertama kali didiagnosis penyakit jantung selama kehamilan. Seorang wanita berusia 24 tahun gravida 32–33 minggu dengan kongesti gagal jantung fungsional kelas III, mitral stenosis berat, ejection fraction (EF) 59%, regurgitasi trikuspid sedang, dan dilatasi atrium kiri menjalani seksio sesarea dengan anestesi spinal dosis rendah menggunakan bupivakaine 0,5% hiperbarik 7,5 mg ditambah fentanyl 50 mcg secara intratekal. Blok sensoris dicapai setinggi torakal 6 dalam waktu 4 menit 20 detik. Hemodinamik pasien stabil selama operasi maupun pasca operasi. Tidak diperlukan pemberian vasopresor. Pasca operasi pasien dirawat di intensive care unit (ICU) selama 3 hari dengan hemodinamik yang stabil. Laporan ini menyoroti bahwa anestesi spinal dosis rendah dapat menjadi pilihan yang baik dalam manajemen anestesi untuk seksio sesarea yang disertai dengan mitral stenosis berat. Low Dose Spinal Anesthesia for Cesarean Section with Severe Mitral Stenosis Abstract Heart disease in pregnancy increases maternal and fetal morbidity and mortality. Mitral stenosis is the most common heart valve lesion in parturient and is almost always caused by rheumatic heart disease. Physiological changes that occur during pregnancy and the peripartum period can worsen symptoms and the degree of the heart disease. As a result, many women are first diagnosed with heart disease during pregnancy. Twenty four year old woman gravida 32–33 weeks with congestive heart failure class III, severe mitral stenosis, EF 59%, moderate tricuspid regurgitation, and left atrial dilatation undergoing cesarean section with low-dose spinal anesthesia using bupivacaine 0,5% hyperbaric 7.5 mg plus fentanyl 50 mcg intrathecally. Sensory blocks were reached as high as thoracic 6th in 4 minutes and 20 seconds. The patient's hemodynamics are stable during both surgery and post surgery. Vasopressors were not needed. After surgery the patient was transferred to ICU for 3 days with stable hemodynamics. This report highlights that low-dose spinal anesthesia can be a good choice in the management of anesthesia for cesarean section accompanied by severe mitral stenosis.

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Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery

Cited by 34 publications

References 29 publications

A Case of Unrecognized Peripartum Cardiomyopathy Which Was Noticed During Emergency Cesarean Section

A Case of Unrecognized Peripartum Cardiomyopathy Which Was Noticed During Emergency Cesarean Section

Emergency Cesarean ın a Patıent Wıth Atrıal Septal Defect

Anestesia Spinal Dosis Rendah untuk Seksio Sesarea pada Pasien Mitral Stenosis Berat

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