Emergent Caesarean section in parturient with congenital complete atrioventricular block

Fahmi, Lukman; Huda, Ali; Azam, Yusoff

doi:10.1258/shorts.2010.010033

Cited by 3 publications

(13 citation statements)

References 5 publications

(9 reference statements)

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“…Pregnant women with a pacemaker who underwent vaginal delivery tolerated the stress of labor well. [4][5][6] Pacemaker insertion per se is not an indication for cesarean section unless there are other obstetric causes for a cesarean section, as in our case. Regional anesthesia can be safely instituted in women where rate and rhythm is maintained by a pacemaker.…”

Section: Discussionmentioning

confidence: 56%

“…On review of literature, there is no consensus regarding the best mode of delivery for these women. Pregnant women with a pacemaker who underwent vaginal delivery tolerated the stress of labor well 4–6 . Pacemaker insertion per se is not an indication for cesarean section unless there are other obstetric causes for a cesarean section, as in our case.…”

Section: Discussionmentioning

confidence: 62%

“…Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy 1–6 …”

Section: Discussionmentioning

confidence: 99%

“…It is best to have a permanent pacemaker inserted in the pre‐pregnancy period; if this is not possible, these symptomatic women should be paced during the first or second trimester 4 . All emergent cases who present either late in pregnancy or during labor should always be counseled regarding a temporary pacemaker, preferably a transvenous type, followed by a permanent pacing in the postpartum period 5 . Because altered hemodynamics can contribute to the patient's symptoms during pregnancy, the patient should therefore be reassessed in the postpartum period before permanent pacemaker implantation is contemplated.…”

Section: Discussionmentioning

confidence: 99%

“…Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy. [1][2][3][4][5][6] Thaman et al reported the natural history of 26 such pregnancies. 2 Their study examined two important but separate groups of patients: the first group of patients included those with a pacemaker already in situ at the time of pregnancy and the second group had untreated bradyarrhythmia or atrioventricular conduction disease at the time of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Management of complete heart block during pregnancy

Dhiman

Sarda

Arora

2012

J of Obstet and Gynaecol

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A 22-year-old second gravida presented to the antenatal clinic at 28 weeks of gestation with frequent fainting attacks (2-3 episodes/day), palpitations and dyspnea (New York Heart Association Functional Classification II). Her pulse rate was 40 b.p.m. A 12-lead electrocardiogram and 24-h Holter revealed complete heart block. A transvenous permanent pacemaker (ventricular demand rate-responsive), paced at a rate of 60 pulses/min, was successfully implanted. A multidisciplinary approach was taken and the patient delivered a healthy baby boy of 2.8 kg at 38 weeks. She remained asymptomatic and was discharged in good condition. Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy. In a young patient with sinus bradycardia, the primary criterion for a pacemaker is the concurrent observation of a symptom (e.g., syncope) with bradycardia (e.g., heart rate 35-40 b.p.m. or asystole for 3 s). Symptomatic pregnant women should always be counseled for a permanent pacemaker.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 62%

“…Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy 1–6 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of complete heart block during pregnancy

Dhiman

Sarda

Arora

2012

J of Obstet and Gynaecol

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Congenital complete heart block in pregnancy

Basri

Ahmad

2018

Hormone Molecular Biology and Clinical Investigation

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Complete heart block (CHB) is infrequently encountered during pregnancy. Its management requires a multidisciplinary approach involving the obstetrician, cardiologist, anesthetist and neonatologist. It varies from conservative, temporary or permanent pacemaker (PPM) insertion (either during the antenatal, intrapartum or postpartum period). We present the case of a 30-year-old, gravida 2 para 1 at the 36-week period of amenorrhea (POA) with congenital CHB. She was asymptomatic throughout her pregnancy despite having a pulse rate between 40 and 50 beats per minute. She delivered a healthy boy via cesarean section due to breech presentation after a failed external cephalic version. A temporary pacemaker was inserted prior to delivery. However, she required permanent insertion of pacemaker during the postpartum period.

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Complete Atrioventricular Block in Pregnancy

Wigin¹,

Hasibuan²,

Soetikno³

et al. 2016

Indones J Obstet Gynecol

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Objective: Complete heart block is an extremely rare and serious complication in pregnancy. Pregnancy outcome in patients with atrioventricular conduction block are unknown, with only a limited number of case reports published. This paper is aimed to report our case and review the available background literature. Method: Case report. Case: A twenty‐nine years old primigravida in labor presented at 38 weeks of gestation with referral from the primary health center due to bradycardia and her previous history of cardiac problem. Patient has been diagnosed with total atrioventricular block since 2 years ago. Electrocardiography assessment showed the presence of complete heart block. She was then planned for an emergency Caesarean section and later a temporary transvenous pacemaker was implanted. Conclusion: Management of complete atrioventricular block in pregnancy requires a good team consisting of obstetrician, anesthesiologist and cardiologist. Keywords: atrioventricular, bradycardia, heart block, pacemaker, pregnancy

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Emergent Caesarean section in parturient with congenital complete atrioventricular block

Cited by 3 publications

References 5 publications

Management of complete heart block during pregnancy

Management of complete heart block during pregnancy

Congenital complete heart block in pregnancy

Complete Atrioventricular Block in Pregnancy

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