Key result
Combined spinal epidural anaesthesia and intravenous calcium channel blockers successfully managed acute atrial fibrillation in a 31-year-old parturient with critical mitral stenosis during emergency caesarean section.
Case Report (n=1)
No
Combined spinal epidural anaesthesia and postpartum intravenous calcium channel blockers can be successfully utilized for emergency caesarean sections in parturients with critical mitral stenosis and acute atrial fibrillation.
May support combined spinal epidural with calcium channel blockers in similar high-risk parturients; hypothesis-generating, prospective trials needed.
A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.
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Gupta et al. (2013) conducted a case report in Critical mitral stenosis with acute atrial fibrillation and fetal distress (n=1). Combined spinal epidural (CSE) anaesthesia and intravenous calcium channel blocker was evaluated on Successful management of arrhythmia and delivery. Combined spinal epidural anaesthesia and intravenous calcium channel blockers successfully managed acute atrial fibrillation in a 31-year-old parturient with critical mitral stenosis during emergency caesarean section.
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