[Anesthesia for caesarean section in a gravida with peripartum cardiomyopathy combined with acute heart failure: a case report].
Peripartum cardiomyopathy(PPCM) is a rare but serious form of  cardiac failure affecting women in the last month of  pregnancy or early puerperium within six months. Clinical presentation of PPCM is similar to that of idiopathic dilated  cardiomyopathy, and maternal mortality is high. An 18 year-old primigravida was admitted to our hospital at the end of forty-one  weeks of gestation. She was diagnosed with PPCM complicated with heart failure. Preoperative optimization was done with a view to  managing left ventricular failure. Continuous epidural anesthesia in the sitting position with lidocaine was used for cesarean section.  The baby was delivered successfully. Intravenous furosemide 20 mg, morphine 10 mg, cedilanid 0.4 mg were given. Nitroglycerin  and milinone infusions continued throughout the surgery titrated to the hemodynamics. The patient received inotropic agents, dieresis,  vasodilators and anticoagulants post-operatively. Both the mother and the baby were discharged safely 9 days after operation.
Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
Hong
H
Zeng
Xiao-xi
XX
Li
Wen-qiu
WQ
Zhao
Xin-heng
XH
Feng
Xiang-yang
XY
Guo
D000293:Adolescent; D000767:Anesthesia, Epidural / Q000379:methods; D000773:Anesthesia, Obstetrical; D009202:Cardiomyopathies / Q000150:complications* / Q000628:therapy; D002585:Cesarean Section; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000628:therapy; D006801:Humans; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular