The Anesthetic Management of a Pre-Term Parturient Undergoing Urgent Cesarean Delivery for Fetal Complications within 30 Days of Drug-Eluting Stent Placement: A Case Report and Literature Review
Journal Title: Journal of Anesthesia and Surgery - Year 2018, Vol 5, Issue 1
Abstract
Cardiomyopathy in pregnancy is a prevalent disease we encounter as obstetric anesthesiologists and can be a major cause of maternal perinatal morbidity and mortality if not appropriately managed particularly during the antepartum period 1 The gold standard of care remains neuraxial anesthesia with adequate labor analgesia and vaginal delivery if feasible 2 However this technique is not always appropriate as women may present with contraindications to neuraxial anesthesia such as women on anticoagulation This is particularly noted in women who have known cardiac disease as women who undergo coronary interventions prior to labor are managed with chemical anticoagulation General anesthetic consideration for this population takes into account not only cardiac techniques but the implications on fetal wellbeing 2 Although maternal outcomes remain our priority as the safety of the mother is necessary for fetal survival improving fetal status at birth is ideal In this particular paper we discuss the challenges we faced in a parturient who underwent percutaneous coronary intervention during her pregnancy and required urgent cesarean section within 30 days of receiving a drug-eluting stent We present the literature surrounding these concerns and the options available to anesthesiologists to provide safe anesthesia for both mother and fetus
Authors and Affiliations
Christy Anthony
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