[Obstructive hypertrophic cardiomyopathy and caesarean section under combined spinal and epidural anaesthesia with prophylactic vascular ligation: regarding a case].
We report the case of a caesarean section under combined spinal and epidural anaesthesia in a pregnant 32-year-old woman with an hypertrophic obstructive cardiomyopathy. In these patients, variations of the ventricular load conditions may induce a cardiac inefficacy. In this context, the post-partum haemorrhage is a feared complication, prevent in part by oxytocine intravenously. However, its injection can be associated with haemodynamic instability, even at a low dose, and it does not spread post-partum haemorrhage. The arterial ligation according to the technique of Tsirulnikov is an alternative that we reported. This technique is followed by a good obstetrical prognosis.
Service d'anesthésie-réanimation, hôpital Bretonneau, CHRU de Tours, université François-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 1, France. jb_dolbeau@yahoo.fr
J-B
JB
Dolbeau
T
T
Hebert
F
F
Espitalier
J
J
Fusciardi
M
M
Laffon
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000000981:diagnostic imaging; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008026:Ligation; D010120:Oxytocics; D010121:Oxytocin; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D014463:Ultrasonography; D055988:Uterine Artery / Q000502:physiology
D010120:Oxytocics; D010121:Oxytocin