Careful multidisciplinary anesthetic management, often utilizing neuraxial anesthesia with incremental dosing or general anesthesia depending on hemodynamic stability, is crucial for safe delivery in women with peripartum cardiomyopathy.
In women with peripartum cardiomyopathy, anesthetic management must be highly individualized, with neuraxial anesthesia preferred for stable patients and general anesthesia reserved for severe decompensated heart failure or emergencies.
Peripartum cardiomyopathy (PPCM) is an uncommon disorder of the cardiovascular system and is linked to high rates of morbidity and mortality. It is an idiopathic condition characterized by left ventricular systolic dysfunction with an ejection fraction of approximately 45% near the end of pregnancy or immediately after delivery. Anesthesia management in these women is challenging due to low physiological reserve and potential negative effects on the fetus. To ensure that mother and child are supported safely through delivery, careful anesthesia control is required. Here, in this review article, we discuss the anesthetic implications in preoperative, operative, and postoperative phases in women with perioperative cardiomyopathy undergoing vaginal delivery or cesarean section.
Nayak et al. (Sat,) conducted a review in Peripartum cardiomyopathy. Anesthetic management was evaluated. Careful multidisciplinary anesthetic management, often utilizing neuraxial anesthesia with incremental dosing or general anesthesia depending on hemodynamic stability, is crucial for safe delivery in women with peripartum cardiomyopathy.