Importance of transesophageal echocardiography in peripartum cardiomyopathy undergoing lower section cesarean section under regional anesthesia

Kapoor, Poonam Malhotra; Goyal, Sameer N.; Irpachi, Kalpana; Barya, Smita

doi:10.4103/0970-9185.137287

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Anesthesiologists are commonly involved during the delivery phase of those parturients with PPCM by providing anesthesia for cesarean section. Either of general or regional anesthesia have been successfully applied in PPCM in multiple of case reports [16,17]. There is no evidence supporting that general is superior to the neuraxial anesthesia, or vice versa.…”

Section: Discussionmentioning

confidence: 99%

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

Su¹,

Y²,

Xp³

et al. 2018

Case Rep Imag Surg

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Background: Peripartum cardiomyopathy is one form of life-threatening dilated cardiomyopathy which occurs in previously healthy women in the final months of pregnancy and up to 5 months after delivery. The etiology of peripartum cardiomyopathy remains poorly understood but inflammation or virus-mediated autoimmune reaction to myocardial cells was proposed to be involved in the pathogenesis of peripartum cardiomyopathy. Obstetric management for those parturients requires communication and careful planning between obstetrics, cardiology and anesthesiology. Case presentation:The first case is a 22-year-old woman presented as gravida 1, para 0, at 38+4 weeks of gestation with the deterioration of dyspnea on exertion and palpitation over the past several days. According to TTE report from cardiac based echocardiography unit, there was a decline in systolic function manifested by overall global wall motion abnormality with EF only 28%. In the second case, A 44-year-old pregnant woman presented at the same hospital with progressing shortness of breath, chest pain and faintness which was diagnose peripartum cardiomyopathy also. Conclusion:The application of point of care echocardiography might have a beneficial impact on the selection of anesthesia and maintaining the hemodynamic stability of the parturient with peripartum cardiomyopathy undergoing cesarean section. This paper reported two parturients suffering from peripartum cardiomyopathy with acute heart failure undergoing lower segmental cesarean section uneventfully throughout the perioperative period under the guidance of point of care transthoracic echocardiography. Highlights• Intraoperative transthoracic echocardiography (TTE) plays an important role in identifying the undifferentiated causes of dyspnea of parturient with peripartum cardiomyopathy (PPCM), decision making on the anesthetic management and also evaluating the response to therapeutic intervention during the low segmental cesarean section (LSCS).• Point of care TTE was a useful tool to detect the global or segmental wall motion abnormality of left ventricle as well as right ventricle filling through utility of continuous noninvasive superficial echocardiography in parturients with PPCM undergoing LSCS.

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Section: Discussionmentioning

confidence: 99%

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

Su¹,

Y²,

Xp³

et al. 2018

Case Rep Imag Surg

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Cardiopulmonary Resuscitation in Obstetric Patient: Special Considerations

Kulkarni

Futane²

2022

J Obstet Gynecol India

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Peripartum Cardiomyopathy

Cunningham

Byrne

Nelson

2019

Obstetrics &Amp; Gynecology

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Peripartum cardiomyopathy is defined by left ventricular dysfunction and development of cardiac failure without a known cause and occurring in the final month of pregnancy and up to 5 months postpartum. Peripartum cardiomyopathy is an important and steadily increasing cause of pregnancy-associated morbidity and mortality. The incidence of peripartum cardiomyopathy in the United States has been estimated recently as 1 in 2,230 births and approximately 1 in 1,000 births worldwide. The etiopathogenesis of peripartum cardiomyopathy remains elusive; however, it is generally thought to be from a two-hit hypothesis in which an underlying cardiomyocyte protein mutation results in apoptosis mediated by vascular and hormonal actions. Clinical recognition is integral to the management of this disease, because there must be careful exclusion of alternative etiologies. Although there are no disease-specific therapies, management of peripartum cardiomyopathy is based on treatment of heart failure and its symptoms, repressing neurohormonal responses, and preventing long-term sequelae. Ventricular function recovery and rates of recurrence of peripartum cardiomyopathy vary by ethnicity and geography. Mortality rates associated with peripartum cardiomyopathy range from 3% to 40%, depending on geographic location. In this review, normal cardiovascular adaptations in pregnancy are summarized and current evidence-based clinical management of the disease is discussed.

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Importance of transesophageal echocardiography in peripartum cardiomyopathy undergoing lower section cesarean section under regional anesthesia

Cited by 3 publications

References 4 publications

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

Cardiopulmonary Resuscitation in Obstetric Patient: Special Considerations

Peripartum Cardiomyopathy

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