Key result
General anesthesia was successfully and safely used for an elective cesarean section in a pregnant woman with severe pulmonary hypertension secondary to mitral stenosis.
Why the study?
RHD remains the most common cause of cardiac disease during pregnancy in India, requiring an understanding of pathophysiology and perioperative management in high-risk patients with severe pulmonary hypertension secondary to mitral stenosis.
Case Report (n=1)
No
General anesthesia can be safely used for cesarean section in patients with severe pulmonary hypertension secondary to mitral stenosis, allowing for meticulous control of ventilatory status and avoiding the risks of epidural anesthesia.
Adds evidence for general anesthesia in cesarean with severe pulmonary hypertension and mitral stenosis; leaves open confirmation in larger studies.
Rheumatic heart disease (RHD) is the most common cause of cardiac disease during pregnancy in India. A case of severe pulmonary hypertension (pulmonary arterial pressure- 98 mm Hg) secondary to mitral stenosis associated with RHD in a 28-year old woman, is described. She underwent a high risk elective cesarean section under general anesthesia at 36 weeks of gestation. The intraoperative and postoperative course was uneventful. The advantages of general anesthesia over neuraxial blockade during cesarean section are discussed in this report. The management of patients at a high risk of developing pulmonary edema and decompensated heart failure in the perioperative period has been stressed upon. A thorough understanding of the pathophysiology and complications of RHD during pregnancy and cesarean section is required for managing the disease successfully.
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Bansal et al. (2020) conducted a case report in Rheumatic heart disease with mitral stenosis and severe pulmonary hypertension in pregnancy (n=1). General anesthesia was evaluated on Maternal and fetal outcome. General anesthesia was successfully and safely used for an elective cesarean section in a pregnant woman with severe pulmonary hypertension secondary to mitral stenosis.
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