Abstract
A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.
Highlights
A 31-year-old lady presented to the antenatal clinic at 34 weeks of gestation with increasing shortness of breath. She was a known case of rheumatic heart disease with mitral stenosis and had undergone balloon mitral valvotomy 12 years ago and closed mitral commissurotomy 7 years ago
Caesarean section is reserved for obstetric indications
We discuss the case of a 34, week antenatal lady with critical mitral stenosis who presented for emergency Caesarean section with acute atrial fibrillation (AF)
Summary
A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. We discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are discussed
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