Anesthetic Management for Hysterotomy in a Pregnant Patient with Eisenmenger Syndrome: a Case Report

Main Article Content

Saranya Lertkovit
Namtip Triyasunant

บทคัดย่อ

Eisenmenger syndrome presents an exceedingly high risk of maternal mortality or severe morbidity, underscoring the need to avoid or promptly terminate a pregnancy. This report outlines the anesthetic management for hysterotomy in a 30-year-old pregnant patient with Eisenmenger syndrome at 17 weeks of gestation, with the objective of pregnancy termination. Successful stabilisation of hemodynamic and minimization of right-to-left shunts were achieved using combined spinal epidural anesthesia. Vigilance in identifying potential intraoperative issues and prompt responses to adverse events were crucial in achieving the desired outcomes.

Article Details

บท
รายงานผู้ป่วย

References

Borges VT, Magalhaes CG, Martins AM, Matsubara BB. Eisenmenger syndrome in pregnancy. Arq Bras Cardiol. 2008;90:e39-40.

Lopez BM, Malhame I, Davies LK, Velez JMG, Marelli A, Rabai F. Eisenmenger syndrome in pregnancy: a management conundrum. J Cardiothorac Vasc Anesth. 2020;34:2813-22.

Arvanitaki A, Giannakoulas G, Baumgartner H, Lammers AE. Eisenmenger syndrome: diagnosis, prognosis and clinical management. Heart. 2020;106:1638-45.

Meng ML, Smiley R. The cardio-obstetrics patient and the cardiothoracic anesthesiologist. J Cardio-thorac Vasc Anesth. 2022;36:546-8.

Duan R, Xu X, Wang X, et al. Pregnancy outcome in women with Eisenmenger’s syndrome: a case series from west China. BMC Pregnancy Childbirth. 2016;16:356.

Slaibi A, Ibraheem B, Mohanna F. Challenging management of a pregnancy complicated by Eisenmenger syndrome; a case report. Ann Med Surg (Lond). 2021;69:102721.

Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39:3165-241.

ACOG Practice Bulletin No. 135: second-trimester abortion. Obstet Gynecol. 2013;121:1394-406.

Meng ML, Fu A, Westhoff C, et al. Eisenmenger syndrome in pregnancy: when is it time for ECMO? A case report. A A Pract. 2018;11:270-2.