Anaesthetic management of emergency caesarean section in a patient with peripartum cardiomyopathy under general anaesthesia - a case report

Authors

  • Dipti Raj Indira Gandhi Institute of Medical Sciences, Bailey Road, Shiekhpura, Patna, Bihar 800014
  • Kumari Priti Jawaharlal Nehru Medical College, Kala Bagh, Ajmer, Rajasthan 305001,
  • Hasina Quari Indira Gandhi Institute of Medical Sciences, Bailey Road, Shiekhpura, Patna, Bihar 800014

Keywords:

caesarean section, general anaesthesia, peripartum cardiomyopathy

Abstract

Peripartum cardiomyopathy is a unique and rare kind of cardiomyopathy of unknown cause that occurs during pregnancy or the postpartum period. Regional anaesthesia for anaesthetic management of this condition has been extensively described. There are limited reports of anaesthetic management of caesarean section of this case under general anaesthesia. We report a case of 32 years old lady diagnosed to have peripartum cardiomyopathy requiring emergency caesarean section that was successfully managed under general anaesthesia. Anaesthetic management was directed towards optimization of myocardial contractility, preload and after load.

Author Biography

Dipti Raj, Indira Gandhi Institute of Medical Sciences, Bailey Road, Shiekhpura, Patna, Bihar 800014

DNB resident, Department of Anaesthesia

References

1. Pearson GD, Veille JC, Rahimtoola S, Hsia J, Oakley CM, Hosenpud JD, et al. Peripartum cardiomyopathy: National Heart; Lung; and Blood Institute and Office of Rare Diseases(National Institutes of Health) workshop recommendations and review. JAMA 2000; 283:1183-8.
http://dx.doi.org/10.1001/jama.283.9.1183
[PMID:10703781]
2. Sliwa K, FettJ, Elkayam U. Peripartum cardiomyopathy. Lancet 2006; 368:687-93.
http://dx.doi.org/10.1016/S0140-6736(06)69253-2
[PMID: 16920474]
3. Shnaider R, Ezri T, Szmuk P, Larson S, Warters DR, Katz J. Combined spinal-epidural- anaesthesia for Cesarean section in a patient with peripartum cardiomyopathy. Can J Anaesth 2001;48:681-3.
http://dx.doi.org/10.1007/BF03016203
[PMID:11495876]
4. Pirlet M, Baird M, Ritson M Jones, Kinsella SM. Low dose combined spinal-epidural anaesthesia for Caesarean section in a patient with peripartum dilated cardiomyopathy. Inter J Obstet Anesth 2000;9:189-92.
http://dx.doi.org/10.1054/ijoa.1999.0374
[PMID:15321091]
5. Velickovic IA, Leicht CH. Peripartum cardiomyopathy and cesarean section: report of two cases and literature review. Arch Gynecol Obstet 2004;270:307-10.
http://dx.doi.org/10.1007/s00404-003-0568-8
[PMID:14685890]
6. Malinow AM, Butterworth JF, Johnson MD, Safon L, Rein M, Hartwell B, et al. Peripartum cardiomyopathy resenting at cesarean delivery. Anesthesiology 1985;63:545-7.
http://dx.doi.org/10.1097/00000542-198511000-00015
[PMID:4051216]
7. Bilehjani E, Kianfar AA, Toofan M, Fakhari S. Anaesthesia with etomidate and remifentanil for caesarean section in a patient with severe peripartum cardiomyopathy-a case report. Middle East J Anesthesiol 2008;19:1141-9.
[PMID:18637614]
8. Zangrillo A, Landoni G, Pappalardo F, Oppizzi M, Torri G. Different anesthesiological management in two high risk pregnant women with heart failure undergoing emergency caesarean section. Minerva Anestesiol 2005;71:227-36.
[PMID:15834351]
9. McCarroll CP, Paxton LD, Elliott P, Wilson DB. Use of remifentanil in a patient with peripartum cardiomyopathy requiring Caesarean section. Br J Anaesth 2001;86:135-8.
http://dx.doi.org/10.1093/bja/86.1.135
[PMID:11575392]
10. Ray P, Murphy GJ, Shutt LE. Recognition and management of maternal cardiac disease in pregnancy. Br J Anaesth 2004;93:428-39.
http://dx.doi.org/10.1093/bja/aeh194
[PMID:15194627]

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Published

2016-03-20

How to Cite

Raj, D., Priti, K., & Quari, H. (2016). Anaesthetic management of emergency caesarean section in a patient with peripartum cardiomyopathy under general anaesthesia - a case report. Journal of Society of Anesthesiologists of Nepal, 3(1), 32-34. Retrieved from http://www.jsan.org.np/jsan/index.php/jsan/article/view/74

Issue

Section

Case Report