Vaginal Delivery in Maternal Cyanotic Congenital Heart Disease-Transposition of Great Arteries
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Transposition of great arteries(TGA) is the most common cyanotic congenital heart disease(CHD). Pregnancy induces hemodynamic changes which in women with CHD, can endanger mother and child. We had two cases of TGA, one had shunt surgery pre-pregnancy, managed efficiently and delivered vaginally without any complications. Both had IUGR. Prostaglandin E1(PGE1) assisted labour induction for case-1 and oxytocin acceleration for case-2 done under infective endocarditis prophylaxis with cardiologist opinion. Uterine, fetal and cardiovascular monitoring done. Under epidural labour analgesia with levobupivacaine, both delivered vaginally, first by vacuum assistance. Postpartum period uneventful. We conclude that appropriate pre-pregnancy counselling, high-risk pregnancy management by multidisciplinary team at tertiary-care centre and effective analgesia, continuous monitoring and assisted second-stage of delivery can decrease the additional haemodynamic load of labour in CHD pregnancies.
Authors and Affiliations
Dr. Meenaakshi Karthikraj PG student, Dr. Kavitha D’Souza Professor & Head
Keywords
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