Successful pregnancy and delivery in a woman with a single ventricle and Eisenmenger syndrome

Boukhris, Marouane; Hakim, Kaouthar; Msaad, Hela; Ouarda, Fatma; Boussaada, Rafik

doi:10.1016/j.jsha.2013.05.001

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…This increases pulmonary arterial pressure and may precipitate heart failure or arrhythmia. Regional anesthesia is potentially risky because it may decrease SVR, which would increase the shunt and exacerbate hypoxemia [18] . When epidural analgesia was chosen for perioperative pain, it reduces PVR and SVR by sympathetic block and reduces catecholamine levels, thus causing less tachycardia, less myocardial oxygen consumption and reduction of the right-to-left shunting [19] .…”

Section: Anesthesiamentioning

confidence: 99%

“…When epidural analgesia was chosen for perioperative pain, it reduces PVR and SVR by sympathetic block and reduces catecholamine levels, thus causing less tachycardia, less myocardial oxygen consumption and reduction of the right-to-left shunting [19] . Boukhris et al [18] successfully used epidural anesthesia in a pregnant woman with a single ventricle and Eisenmenger syndrome and provided excellent analgesia. General anaesthesia can lower SVR remarkably thereby worsening the right-to-left shunting and leading to a difficult extubation.…”

Section: Anesthesiamentioning

confidence: 99%

“…Nitric oxide inhalation during the labor in the pregnant woman with Eisenmenger syndrome may improve oxygenation and attenuate pulmonary arterial pressure [18,27] . Inhaled nitric oxide also has an antithrombotic effect [28] .…”

Section: Treatmentmentioning

confidence: 99%

“…At least 54.9% of all deliveries occurred prematurely [39] . Neither the mode and timing of delivery nor the type of anesthesia and monitoring correlated with maternal outcome [18] . A delayed diagnosis, a delayed presentation to hospital and severity of PAH have been found to be contributing risk factors [18] .…”

Section: Prognosismentioning

confidence: 99%

“…Neither the mode and timing of delivery nor the type of anesthesia and monitoring correlated with maternal outcome [18] . A delayed diagnosis, a delayed presentation to hospital and severity of PAH have been found to be contributing risk factors [18] . Cesarean sections and other operations are associated with extremely high maternal mortality during pregnancy [38] .…”

Section: Prognosismentioning

confidence: 99%

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Eisenmenger Syndrome in Pregnancy

Yuan¹

2016

Brazilian Journal of Cardiovascular Surgery

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Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Epidural analgesia is preferred for Cesarean section as it alleviates perioperative pain and reduces the pulmonary and systemic vascular resistances. Maternal mortality in the presence of Eisenmenger syndrome is reported as 30-50% and even up to 65% in those with Cesarean section. The major causes of death could be hypovolemia, thromboembolism and preeclampsia. Pregnancy should ideally be avoided in a woman with Eisenmenger syndrome concerning the high maternal mortality rate and probable poor prognosis of the baby. A short labour and an atraumatic delivery under epidural block are preferred in the women with a strong desire of pregnancy. The purpose of this article is to discuss the debates of Eisenmenger syndrome in pregnancy and the possible resolutions.

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Section: Anesthesiamentioning

confidence: 99%

Section: Anesthesiamentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

See 3 more Smart Citations

Eisenmenger Syndrome in Pregnancy

Yuan¹

2016

Brazilian Journal of Cardiovascular Surgery

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Multidisciplinary management of a pregnant woman with uncorrected transposition of the great arteries at term pregnancy: A case report

Reyther

Garcia

Larraga

et al. 2022

Intl J Gynecology & Obste

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Long‐term survival of patients with unoperated single ventricle heart defect: Four case reports and literature review

Zhao

Guo

Sun

et al. 2022

J of Clinical Ultrasound

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A single ventricle (SV) heart defect is a rare complex congenital cardiac malformation, accounting for approximately 1%–2% of congenital heart diseases. Surgical intervention is the mainstay treatment for SV patients, although patients who do not receive surgical intervention may also survive. We followed up four adult patients who had SV since birth without surgical intervention and they had a good prognosis. The common characteristics of four long‐term SV survivors were investigated by reviewing their medical records and the literature, and the current treatment methods for SV patients were also reviewed. The clinical presentation and long‐term prognosis of SV patients without surgical intervention depend on the presence or absence of pulmonary blood flow obstruction, pulmonary vascular resistance, ventricular shape and function, aortic blood flow obstruction, and the atrioventricular valve shape and function. While the Fontan operation has become a common and effective method for SV treatment, long‐term outcomes are fraught with morbidity and mortality. In our opinion, such patients with balanced hemodynamic condition could be followed and treated conservatively. Major cardiac surgery which leads to gross hemodynamic adjustments should be avoided. However, additional prospective study will be necessary to verify this assertion. This report aims to improve the prognosis as well as quality of life of SV patients.

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Successful pregnancy and delivery in a woman with a single ventricle and Eisenmenger syndrome

Cited by 10 publications

References 13 publications

Eisenmenger Syndrome in Pregnancy

Eisenmenger Syndrome in Pregnancy

Multidisciplinary management of a pregnant woman with uncorrected transposition of the great arteries at term pregnancy: A case report

Long‐term survival of patients with unoperated single ventricle heart defect: Four case reports and literature review

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