Anaesthetic management of aortic coarctation in pregnancy.
We report two cases of aortic coarctation in pregnancy. The first was a 20-year-old nulliparous woman who underwent an aortic coarctation repair when she was 23 weeks old and subsequently developed an aneurysm at the site of initial repair. The second was a 20-year-old nulliparous woman with a severe uncorrected congenital aortic coarctation and upper body hypertension, who became pregnant whilst awaiting transcatheter dilatation of the coarctation. Antenatal care involved a multidisciplinary approach with obstetric, anaesthetic and cardiology input. Both parturients were delivered by elective caesarean section. A cautious, incremental regional anaesthetic technique was used, with no associated maternal or neonatal morbidity. Perioperative management focused on minimising haemodynamic disturbances. The management is discussed, together with the potential maternal and fetal complications of aortic coarctation in pregnancy.
Walker
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Department of Anaesthesia, Birmingham Women's Hospital, Edgbaston, Birmingham, UK. ewalkere@doctors.org.uk
Malins
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AF
D000328:Adult; D000773:Anesthesia, Obstetrical; D001017:Aortic Coarctation / Q000150:complications* / Q000473:pathology; D001034:Apgar Score; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D010149:Postoperative Pain / Q000188:drug therapy; D011182:Postoperative Care; D011247:Pregnancy