Isoprenaline infusion in the peripartum period for a parturient with congenital complete heart block

Abstract

SummaryWe describe the successful peripartum management of a patient with isolated congenital complete heart block using an isoprenaline infusion. A 21‐year‐old lady presented in established labour. She had previously been diagnosed with isolated congenital complete heart block but had never been symptomatic and was lost to follow up. Peripartum management was a therapeutic challenge due to the high risk of syncope, convulsions and sudden death from the increased demand on the heart during labour. There are no established guidelines on the management of congenital complete heart block in pregnancy. Our patient was managed successfully with an isoprenaline infusion titrated to achieve a target heart rate of 50‐60 beats.min‐1 so as to comply with the increased cardiovascular demands during labour. We believe that this is the first reported case of isoprenaline use for complete heart block in labour.