title: Neurally Mediated Syncope During Cesarean Delivery: A Case Report.
abstract: A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia.
authors.affiliation: From the *Department of Anesthesiology, Fukuoka University Hospital, Fukuoka, Japan; and †Operating Rooms, Fukuoka University Hospital, Fukuoka, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Sato
authors.forename: Erisa
authors.initials: E
authors.lastname: Nakamori
authors.forename: Go
authors.initials: G
authors.lastname: Kusumoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Ken
authors.initials: K
authors.lastname: Yamaura
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001919:Bradycardia / Q000209:etiology*; D016887:Cardiopulmonary Resuscitation; D002585:Cesarean Section; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications; D005996:Nitroglycerin / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000601:surgery*; D011247:Pregnancy; D011312:Pressure; D012307:Risk Factors; D019462:Syncope, Vasovagal / Q000150:complications*
chemical_list: D005996:Nitroglycerin