Key result
A 31-year-old parturient with an incidental finding of congenital complete heart block successfully delivered a healthy baby via emergency cesarean section under spinal anesthesia with temporary pacemaker backup.
Why the study?
Congenital complete heart block is rare, can remain asymptomatic until pregnancy, and carries high mortality and morbidity.
Case Report (n=1)
This case highlights the critical role of standard ASA monitoring, including a 12-lead ECG, in detecting and safely managing previously asymptomatic congenital complete heart block in pregnant women presenting in active labor.
Alerts clinicians to congenital complete heart block in parturients with effort intolerance; leaves open optimal peripartum management strategies.
Congenital complete heart block is a rare occurrence. In some cases, it remains asymptomatic until adulthood or in the case of women until pregnancy. It is usually secondary to placental transfer of maternal antibodies and is associated with high mortality and morbidity. We present a case of a parturient who presented in active labor with premature rupture of membranes and decreased fetal movements. We found that the patient had a complete heart block with mild effort intolerance on evaluation. Markers for metabolic and ischemic causes were negative, and we made a provisional diagnosis of congenital complete heart block. The patient underwent a lower section cesarian section under spinal anesthesia with temporary pacemaker backup. Postoperatively, the patient underwent permanent pacemaker implantation. This case report underlines the importance of standard American Society of Anesthesiologists (ASA) monitoring, including a 12-lead electrocardiogram (ECG), which could prove decisive and life-saving in dire circumstances.
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Bora et al. (2022) conducted a case report in Congenital complete heart block in active labor (n=1). Emergency cesarean section under spinal anesthesia with temporary pacemaker implantation was evaluated on Maternal and fetal outcome. A 31-year-old parturient with an incidental finding of congenital complete heart block successfully delivered a healthy baby via emergency cesarean section under spinal anesthesia with temporary pacemaker backup.
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