Anaesthetic Management in a Case of Peripartum Cardiomyopathy and Seizure Disorder- A Case Report

Abstract

BACKGROUND Dilated cardiomyopathy (DCM) is a form of cardiomyopathy characterised by left ventricular or biventricular dilatation and impaired ventricular contractility. Peripartum cardiomyopathy (PPCM) is a disease affecting the parturient during late pregnancy or immediately after delivery. It has an incidence of one per 3500 live births and is associated with a high mortality rate (30-60%). [1] The major concern while managing these patients is to optimise fluid administration and avoid myocardial depression, while maintaining stable intraoperative haemodynamics. Seizure disorders are 2 nd most prevalent and most serious neurological conditions encountered in pregnant women after migraine. Epilepsy can affect the course of pregnancy, labour, delivery and alter the foetal development whereas pregnancy can exacerbate epilepsy. [2,3] Metabolism of antiepileptic medications during pregnancy is changed and teratogenic effects of several anticonvulsant medications are unquestioned. Anaesthetic management of such cases poses a challenge due to the increased risk of various perioperative complications. We report the successful anaesthetic management of a patient with PPCM and seizure disorder posted for Suction Evacuation with Sterilisation.