title: PGE1 nebulisation during caesarean section for Eisenmenger's syndrome: a case report.
abstract: BACKGROUND
  Eisenmenger's syndrome in pregnancy can lead to death in 50% to 65% of parturients. Expensive invasive monitoring and medication have improved management and outcomes. Cheaper alternatives for the management of high-risk patients who present with no prenatal care are still not available.
  
  
  METHODS
  We describe the obstetric anaesthesia management of a 34-year-old, 34-weeks pregnant woman who presented with a recent diagnosis of severe Eisenmenger's syndrome. A combined spinal epidural anaesthesia was used together with invasive cardiac monitoring as well as PGE1 nebulisation after delivery of the baby. This helped achieve a reduction of shunt, improvement of hypoxia and reduction of pulmonary pressures.
  
  
  CONCLUSIONS
  We found this to be a cheaper and safe alternative in the management of such patients who present with no adequate prior management.
authors.affiliation: Department of Anaesthesia, Aga Khan University, Karachi, Pakistan. shahla.siddiqui@aku.edu
authors.forename: Shahla
authors.initials: S
authors.lastname: Siddiqui
authors.forename: Naveed
authors.initials: N
authors.lastname: Latif