Anesthesia for a primipara delivery with concomitant right to left shunt heart disease
Medical Review (Med. pregled), 2025, 61(4), 44-49.
G. Penev1,2, Е. Кarjin1
1 University Obstetrics and Gynecology Hospital „Maichin dom“ – Sofia
2 Faculty of Public Health, Medical University – Sofia
Abstract. Nowadays, the heart diseases are still the most common indirect cause of maternal mortality worldwide. Congenital heart disorders (CHDs) can significantly affect cardiac function. According to statistics, CHDs are encountered by about 1% of the population and are the main cause (about 80%) for the morbidity of pregnant women. Cardiomyopathies, rhythm and conduction hearth disorders are excluded from this etiology. The etiology of the CHDs is usually various and multifactorial. Due to improved surgical techniques nowadays а lot of women with CHDs are cured, reaching fertile age, i.e., they can become pregnant. We present a casereport of a 29-year-old primigravida in 33-th gestational week with a CHD and chronic hypoxemia due to right-to-left cardiac shunt. The shunt appeared after surgical correction of pulmonary vascular atresia in neonatal age. The patient has comorbidities. The patient presented with cerebral palsy, epilepsy on medical treatment and preeclampsia. The patient’s preoperative general condition, operative ap- proach, choice of anesthesia and postoperative reconvalescence are discussed.
Key words: septal defect, chronic cyanosis, cesarean section, anesthesia