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Beijing Da Xue Xue Bao · Oct 2012
Case Reports[Anesthesia for caesarean section in a gravida with peripartum cardiomyopathy combined with acute heart failure: a case report].
- Hong Zeng, Xiao-xi Li, Wen-qiu Zhao, Xin-heng Feng, and Xiang-yang Guo.
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
- Beijing Da Xue Xue Bao. 2012 Oct 18; 44 (5): 804-7.
AbstractPeripartum cardiomyopathy(PPCM) is a rare but serious form of cardiac failure affecting women in the last month of pregnancy or early puerperium within six months. Clinical presentation of PPCM is similar to that of idiopathic dilated cardiomyopathy, and maternal mortality is high. An 18 year-old primigravida was admitted to our hospital at the end of forty-one weeks of gestation. She was diagnosed with PPCM complicated with heart failure. Preoperative optimization was done with a view to managing left ventricular failure. Continuous epidural anesthesia in the sitting position with lidocaine was used for cesarean section. The baby was delivered successfully. Intravenous furosemide 20 mg, morphine 10 mg, cedilanid 0.4 mg were given. Nitroglycerin and milinone infusions continued throughout the surgery titrated to the hemodynamics. The patient received inotropic agents, dieresis, vasodilators and anticoagulants post-operatively. Both the mother and the baby were discharged safely 9 days after operation.
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