Anesthetic Management for Cesarean Delivery in a Patient With Pulmonary Emboli, Pulmonary Hypertension, and Right Ventricular Failure. A A Case Rep 2016 Oct 01;7(7):146-9
Date
08/16/2016Pubmed ID
27513968DOI
10.1213/XAA.0000000000000367Scopus ID
2-s2.0-85021851768 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
The maternal mortality rate for parturients with severe pulmonary hypertension is 30% to 50%. General, epidural, and combined low-dose spinal-epidural anesthesia have been used successfully for cesarean deliveries in patients with pulmonary hypertension. We describe a cesarean delivery performed using an intrathecal catheter in a 25-year-old morbidly obese (body mass index, 82 kg/m) woman (gravida 3, para 2 at 32 weeks of gestation) who had severe pulmonary hypertension, right ventricular failure, pulmonary emboli, and obstructive sleep apnea. We discuss the anesthetic considerations for parturients with severe pulmonary hypertension undergoing cesarean delivery including the selection of anesthetic technique, vasopressors, and uterotonic agents.
Author List
Patel S, Weierstahl KL, Shah S, Fidkowski CWAuthor
Krystal Weierstahl DO Assistant Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnesthesia, Obstetrical
Anesthesia, Spinal
Cesarean Section
Female
Heart Failure
Humans
Hypertension, Pulmonary
Obesity, Morbid
Pregnancy
Pregnancy Complications, Cardiovascular
Pulmonary Embolism
Ventricular Dysfunction, Right
