Abstract

CASE REPORT: ANAESTHETIC MANAGEMENT FOR CAESAREAN SECTION IN PREGNANT WOMAN WITH SEVERE PULMONARY ARTERY HYPERTENSION DUE TO MITRAL STENOSIS

Dr. Irshad B.* MD, Dr. R. Yogarajan MD and Dr. Prakash V. MD

Abstract

Introduction: Pulmonary artery hypertension (PAH) in pregnancy is known to cause high maternal mortality. we report the peri-operative management of a case of Pulmonary artery hypertension due to mitral stenosis. Case Report: A 28 year old primi gravida presented with progressive dyspnea on exertion, multiple episodes of hemoptysis at 27 weeks of gestation. she was diagnosed to have severe pulmonary artery hypertension and caesarean section was planned at 34 weeks of gestation. A combined spinal and epidural anaesthesia was used along with invasive cardiac monitoring. Conclusion: We preferred to continue spinal anaesthesia because gradually increasing the local anaesthetic dose during the procedure may minimize probable undesirable hemodynamic changes, such as hypotension and tachycardia.

Keywords: Mitral Stenosis, Pulmonary hypertension, Pulmonary vascular resistance, Regional Anaesthesia.