title: Complete heart block in pregnancy: case report, analysis, and review of anesthetic management.
abstract: Maternal complete heart block can pose significant challenges for the anesthesiologist in the antepartum, peripartum, and postpartum periods. Some patients may present for the first time in the puerperium with dizziness, weakness, syncope, or congestive heart failure as a result of the additional hemodynamic burden that accompanies pregnancy. Although there is an increase in permanent pacemaker placement in young symptomatic patients before pregnancy, prophylactic placement of pacemakers in asymptomatic parturients is not always indicated. The need for temporary or permanent pacemakers in asymptomatic women should be assessed on a case-by-case basis; many of these patients may be safely managed during labor and delivery without pacing. The parturient with complete heart block must be followed vigilantly during pregnancy and post delivery, as the need for pacemaker insertion can also arise in the postpartum period. We present a case of third-degree heart block in a 26-year-old parturient.
authors.affiliation: Department of Anesthesiology, University of Miami Miller School of Medicine, C-300, 1611 NW 12 Ave, Miami, FL 33136 USA.
authors.forename: Lalitha
authors.initials: L
authors.lastname: Sundararaman
authors.affiliation: Department of Anesthesiology, University of Miami Miller School of Medicine, C-300, 1611 NW 12 Ave, Miami, FL 33136 USA. Electronic address: JHochman@med.miami.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hochman Cohn
authors.affiliation: Department of Anesthesiology, University of Miami Miller School of Medicine, C-300, 1611 NW 12 Ave, Miami, FL 33136 USA.
authors.forename: J Sudharma
authors.initials: JS
authors.lastname: Ranasinghe
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods*; D054537:Atrioventricular Block / Q000628:therapy*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D014620:Vacuum Extraction, Obstetrical / Q000379:methods