International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2020
Case ReportsCongenital complete heart block in the setting of severe pre-eclampsia requiring urgent Cesarean section.
Congenital complete heart block is a rare phenomenon that may be discovered during pregnancy in patients who were previously asymptomatic. Peripartum management of these patients mandates a multidisciplinary approach with careful planning regarding indications for pacing, appropriate anesthetic technique, and contingency planning. Approaches to anesthetic management for congenital complete heart block have been described, but management in association with severe pre-eclampsia has not been reported. We describe the anesthetic management of a parturient with complete heart block who presented with severe pre-eclampsia requiring urgent cesarean section.
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Int J Obstet Anesth · Nov 2020
Case ReportsCesarean delivery in a parturient with a left ventricular assist device.
Left ventricular assist devices are implanted pumps designed to treat patients with heart failure, and in some cases, to be a bridge to transplantation for patients who qualify. The preconception presence of a left ventricular assist device is a relative contraindication to pregnancy. ⋯ Her medical history was significant for the presence of a left ventricular assist device, inserted due to heart failure associated with polysubstance abuse. To our knowledge, this is the first description of successful cesarean delivery under neuraxial anesthesia of a parturient with a left ventricular assist device.