Maternal and Foetal Outcome in Eisenmenger Pregnancies: A Prospective Observational Study

Gnanaraj, Justin Paul; Princy, Anne; Gnanaprakasam, Thirumal; Balu, Karthikeyan; Anju, Surendran S.; Manimegalai, Elavarasi; Venkatesan, S.; Ravishankar, G.; Manohar, G.; Nagarajan, Swaminathan; Vijaya, S.; Meena, S; Suresh, Meena; Gomathi, K; Kanmani, K

doi:10.1016/s0735-1097(22)02965-5

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“…Adverse events also occur in the fetus which has a high risk of spontaneous abortion, intrauterine growth restriction, preterm birth, low birth weight, and congenital heart disease. [2][3][4][5][6] Anesthesia in pregnant patients with comorbid Eisenmenger syndrome who are planned for caesarean section is a challenge for anesthesiologists. Patients are expected to have no significant decrease in systemic vascular resistance (SVR) and no increase in pulmonary vascular resistance (PVR).…”

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confidence: 99%

Low Dose Spinal Anesthesia in Pregnant Patient with Eisenmenger Syndrome undergoing Caesarean Section

Tanuwijaya,

Aryasa

2024

J. Med. Health

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Pregnancy with Eisenmenger syndrome is pregnancy with a high mortality rate and it is even recommended not to get pregnant based on the World Health Organization pregnancy risk. The aim of this paper is to present a choice of anesthetic techniques to facilitate pregnant patients with Eisenmenger syndrome undergoing caeasarean section. A 25-year-old woman at 37 weeks' gestation came to the hospital with signs of labor accompanied by comorbid Eisenmenger syndrome. Caesarean section was facilitated with spinal anesthesia with bupivacaine heavy 0.5% 7.5 mg, fentanyl 25 mcg at level L2-L3 while loading 250 ml of crystalloid fluid and preparing norepinephrine drip. The patient's hemodynamics can be stabilized by titrating norepinephrine drip to 0.2 mcg/kg/minute and the patient's shortness of breath is gradually reduced. The patient was treated in intensive care for 2 days and was allowed to be outpatient after 5 days of being treated in the postnatal ward. Appropriate perioperative management can provide optimal results and is expected to prevent fatal perioperative events. As conclusion, low-dose spinal anesthetic techniques can be an option to facilitate caesarean section in pregnant patients with Eisenmenger syndrome.

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