Epidural anesthesia is recommended for pregnant patients with fixed-rate pacemakers based on a case of severe fetal acidosis following spinal anesthesia.
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Spinal anesthesia may risk fetal acidosis in fixed-rate pacemaker pregnancies; this case report leaves optimal anesthesia choice open for study.
Two pregnancies in a patient with a fixed-rate pacemaker are reported. The first pregnancy was uneventful. The second had no maternal complications either. A moderate tachysystolia was detected during the second period. The newborn was delivered with forceps applied under spinal anesthesia. Newborn infant evolution presented no hazards, but umbilical cord analysis revealed a severe acidosis, in spite of a normal scalp analysis 45 min earlier. Epidural anesthesia is recommended for such patients.
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Matorras et al. (1991) studied this question.
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