Abstract :
The management of pregnant women with congenital heart diseases is a complex and challenging task, particularly as these conditions are becoming more common with advancements in medical and surgical treatments. Pulmonary hypertension in pregnancy, classified as class IV by the World Health Organization (WHO), presents a significant hemodynamic burden due to circulatory changes during pregnancy. This condition is associated with a high risk of maternal morbidity and mortality, making careful management essential for optimal outcomes.A pregnant patient with a repaired large ventricular septal defect (VSD) measuring 14 mm, complicated by severe pulmonary hypertension (75 mm Hg), was planned for a cesarean section. The procedure was performed under epidural anesthesia using a combination of 0.75% Ropivacaine and 2% Lignocaine, with the drug doses titrated to effect.A well-planned and executed epidural anesthesia, with appropriate selection of epidural drugs and doses, can serve as an effective anesthetic modality for cesarean delivery in patients with cardiac conditions, offering safety and optimal outcomes in complex clinical scenarios.
Keyword :
Epidural anaesthesia, Pregnancy, Congenital heart disease, Ventricular septal defect, Pulmonary hypertension.