Anaesthetic Management for Caesarean Section Surgery in Two Pregnant Women with Severe Pulmonary Hypertension Due to Mitral Valve Stenosis

Abstract

Background: Mitral stenosis is the most important and common cardiac complication seen during pregnancy. Conception is discouraged in cases where pulmonary hypertension develops during the course of mitral stenosis. Successful general and regional anaesthetic interventions have been reported in some cases of severe pulmonary hypertension. Case Reports: We present our experiences with anaesthetic management in two pregnant patients with pulmonary hypertension due to mitral valve stenosis. Conclusion: We preferred to continue spinal anaesthesia because gradually increasing the local anaesthetic dose during the procedure may minimise probable undesirable haemodynamic changes, such as hypotension and tachycardia. Turkish Başlık:Mitral Darlığa Bağlı Şiddetli Pulmoner Hipertansiyonu Olan 2 Gebede Sezaryen İçin Anestezi Yönetimi Anahtar Kelimeler:Mitral darlık, pulmoner hipertansiyon, sezaryen, rejyonel anestezi Arkaplan: Mitral stenoz gebelikte kardiyak komplikasyonlara yol açabilen önemli bir durumdur. Mitral stenoz seyri sırasında pulmoner arteryel (PAH) hipertansiyon gelişen hastalara gebe kalmaları önerilmez. Literatürde ileri derecede PAH'lu gebelere genel ve rejyonel anestezinin başarı ile uygulandığına dair örnekler rapor edilmiştir. Olgu Sunumu: Mitral darlığına bağlı pulmoner hipertansiyonu olan 2 gebe hastamızdaki anestezi yönetimimizi sunmayı amaçladık. Sonuç: Biz bu olgularda istenmeyen hemodinamik değişiklikleri (hipotansiyon ve taşikardi gibi) minimalize edebilmek için lokal anestezi dozunun yavaş yavaş artırılabildiği kontinyu spinal anesteziyi öneriyoruz.

Keywords

• Mitral Stenosis, pulmonary hypertension, caesarean section, regional anaesthesia

Anaesthetic Management for Caesarean Section Surgery in Two Pregnant Women with Severe Pulmonary Hypertension Due to Mitral Valve Stenosis

Öz

Kaynakça

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