Epidural analgesia for labour and delivery in a parturient with congenital hypertrophic obstructive cardiomyopathy.
We report a parturient delivering vaginally at term with symptomatic congenital hypertrophic obstructive cardiomyopathy. Epidural analgesia was used during labour and delivery and is likely to have made a useful contribution to the successful outcome. Although controversial, reported use of epidural analgesia during labour for hypertrophic obstructive cardiomyopathy parturients has been generally positive. A multi-disciplinary team approach, early anaesthetic assessment and a carefully managed epidural catheter inserted in early labour can optimize analgesia and minimize the stresses of labour and vaginal delivery provided the risks of reduced preload and afterload are minimized.
Department of Obstetric Anaesthesia, Women and Children's Hospital, Adelaide, South Australia.
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Paix
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Cyna
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Belperio
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Simmons
D000328:Adult; D000577:Amides; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000779:Anesthetics, Local; D002045:Bupivacaine; D002312:Cardiomyopathy, Hypertrophic / Q000151:congenital*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine