Anesthetic Management in a Parturient with Complete Heart Block Posted for Emergency Uterine Evacuation: A Case Report

Aaditya A Prabhudesai, Kasturi H Bandyopadhyay, Chumki A Datta, Shilpita Banerjee
2019 MGM Journal of Medical Sciences  
A 34-year-old lady in the 19th week of gestation was referred for emergency evacuation of products of conception, following intrauterine fetal death and persistent vaginal bleeding. She was suffering from complete heart block with a heart rate of 42 beats per minute. A temporary pacemaker was implanted and she was taken up for surgery. She developed an acute bronchospasm just before induction of anesthesia, which was successfully managed, without delaying the operative procedure. Her anesthetic
more » ... ure. Her anesthetic management is discussed in detail in this paper. She was discharged on the 8th postoperative day after implanting a permanent pacemaker. Cause of her complete heart block was found to be systemic lupus erythematosus. bAckground Complete heart block (CHB) in pregnancy is uncommon. 1 Recurrent mid-trimester abortions are common owing to immunologic factors associated with diseases such as systemic lupus erythematosus (SLE), Sjögren's syndrome, systemic infections, placental pathologies, thrombophilia, and diabetes. 2 Our case was complicated by a sudden, unexpected preoperative bronchospasm that dictated a prompt management of the respiratory emergency, making the management of general anesthesia more challenging.
doi:10.5005/jp-journals-10036-1241 fatcat:vj4a5ukctved5fjvwcrbsgzcei