Double Invasive Blood Pressure Monitoring for Cesarean Delivery in a Pregnant Woman With Aortic Coarctation.
Aortic coarctation is a discrete narrowing of the proximal thoracic aorta. It is poorly tolerated during pregnancy because of its association with hypertension, cerebrovascular accident, and aortic rupture. We report a case of severe uncorrected congenital aortic coarctation in a 31-year-old symptomatic pregnant woman at 29 weeks of gestation who underwent successful cesarean delivery with an epidural anesthetic technique. Transthoracic echocardiography showed a gradient of 75 mm Hg. To avoid undiagnosed arterial hypotension and inadequate uteroplacental flow distal to the coarctation, double (radial and femoral) invasive arterial blood pressure measurement was used to monitor both pre- and postcoarctation arterial blood pressure.
From the *Department of Anesthesiology, and †Department of Obstetrics and Gynecology, Hospital Universitário Antônio Pedro, Rio de Janeiro, Brazil.
Bruno Mendonça
BM
Barcellos
Fernanda Martins
FM
Loureiro
Livia Fernandes
LF
Sampaio
Marco Antonio Cardoso
MA
de Resende
D000328:Adult; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging*; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods*; D002585:Cesarean Section / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*