Document Detail


General anaesthesia for emergency caesarian section in a patient with Eisenmenger's syndrome and pre-eclampsia.
MedLine Citation:
PMID:  16164163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancy is poorly tolerated in patients with Eisenmenger syndrome (ES) with maternal mortality of 30-50%. Physiological changes of pregnancy decreases systemic vascular resistance that further aggravates the bi-directional or right to left shunt associated with ES. When it occurs with eclampsia, the morbidity and mortality are even higher. We report a case of 30 weeks pregnant woman with ES, who underwent emergency caesarian section because of pre-eclampsia. The intra-operative course was uneventful but she died on the second post-operative day. Post-operatively she was managed by the cardiologist in the coronary care unit. The probable cause being that she was over transfused, as the fluid status was not assessed by any invasive monitoring (like CVP). It was concluded that patients should be monitored closely in the post-operative period in the intensive care unit with complete invasive monitoring for up to a week to prevent factors resulting in worsening of the shunt (such as fluid balance) and thromboembolic phenomenon.
Authors:
Aziza M Hussain; Samina Ismail; Rehana S Kamal
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  JPMA. The Journal of the Pakistan Medical Association     Volume:  55     ISSN:  0030-9982     ISO Abbreviation:  J Pak Med Assoc     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-16     Completed Date:  2005-12-02     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  7501162     Medline TA:  J Pak Med Assoc     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  348-50     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Aga Khan University Hospital, Karachi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General*
Anesthesia, Obstetrical / methods*
Cesarean Section*
Eisenmenger Complex / complications*
Emergency Treatment*
Fatal Outcome
Female
Humans
Intensive Care Units
Monitoring, Physiologic
Postoperative Care
Pre-Eclampsia / physiopathology*
Pregnancy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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