Double Invasive Blood Pressure Monitoring for Cesarean Delivery in a Pregnant Woman With Aortic Coarctation

Abstract

Aortic coarctation is a discrete narrowing of the proximal thoracic aorta. It is poorly tolerated during pregnancy because of its association with hypertension, cerebrovascular accident, and aortic rupture. We report a case of severe uncorrected congenital aortic coarctation in a 31-year-old symptomatic pregnant woman at 29 weeks of gestation who underwent successful cesarean delivery with an epidural anesthetic technique. Transthoracic echocardiography showed a gradient of 75 mm Hg. To avoid undiagnosed arterial hypotension and inadequate uteroplacental flow distal to the coarctation, double (radial and femoral) invasive arterial blood pressure measurement was used to monitor both pre- and postcoarctation arterial blood pressure.

Aortic coarctation and pregnancy: anesthesia management in two Cesarean sections with invasive and non-invasive measurement of blood pressure in both upper and lower limbs

“…Bruno Mendonça Barcellos and colleagues recently presented a Cesarean delivery in a patient with an uncorrected AoCo but a surgically corrected VSD. 13 They used epidural anesthesia with invasive blood pressure monitoring in both upper and lower limbs and achieved a desirable outcome.…”