General anesthesia for caesarean delivery in a pregnant woman affected by acute myocardial infarction

Acute myocardial infarction rarely occurs in women during childbearing age (1:20,000), but maternal mortality rate is high (11%). Management of pregnant woman affected by myocardial infarction could be a challenge for obstetricians, cardiologists and anesthetists. In this report, we present the mana...

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Bibliographic Details
Published inEuropean review for medical and pharmacological sciences Vol. 16; no. 8; p. 1123
Main Authors Frassanito, L, Vagnoni, S, Zanfini, B A, Catarci, S, Maggiore, S, Draisci, G
Format Journal Article
LanguageEnglish
Published Italy 01.08.2012
Subjects
Adult
Anesthesia, General
Anesthesia, Obstetrical
Cesarean Section
Female
Humans
Myocardial Infarction - physiopathology
Pregnancy
Pregnancy Complications, Cardiovascular - physiopathology
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Summary:Acute myocardial infarction rarely occurs in women during childbearing age (1:20,000), but maternal mortality rate is high (11%). Management of pregnant woman affected by myocardial infarction could be a challenge for obstetricians, cardiologists and anesthetists. In this report, we present the management of a 36 years-old nulliparous woman affected from hypertension and dyslipidemia, who experienced acute myocardial infarction at 25th gestational week and was scheduled for caesarean delivery at 35th week. General anesthesia for cesarean section was conducted using sevoflurane and remifentanil target controlled infusion (TCI); the patient was monitored with ECG, pulse oximetry, invasive blood pressure, haemodynamic measurement by lithium dilution cardiac output (LiDCO plus) and bispectral index. The titrated use of remifentanil and the close control of hemodynamic parameters by LiDCO plus monitoring may contribute to improve maternal outcome and newborn well-being in the management of general anesthesia for caesarean section.
ISSN:1128-3602