A STUDY ON PERIOPERATIVE OUTCOME OF PARTURIENTS WITH MITRAL STENOSIS UNDERGOING ELECTIVE CAESAREAN SECTION UNDER EPIDURAL ANAESTHESIA

Dr. S. Ramadevi; Dr. C. Chitra

Volume : VII, Issue : V, May - 2018

A STUDY ON PERIOPERATIVE OUTCOME OF PARTURIENTS WITH MITRAL STENOSIS UNDERGOING ELECTIVE CAESAREAN SECTION UNDER EPIDURAL ANAESTHESIA

Dr. S. Ramadevi, Dr. C. Chitra

Abstract :

Rheumatic heart disease is the commonest cardiac disease complicating pregnancy in developing countries.Heart disease accounts for 15% pregnancy related mortality. In the presence of maternal heart disease, the circulatory changes of pregnancy may result in exacerbation of the haemodynamic perturbations due to complex cardiac valvular lesions.Determining the ideal anesthetic technique for Caesarean section in presence of such cardiac conditions remains a much debated topic. General anaesthesia is associated with a further increase in pulmonary pressure in response to laryngoscope and intubation along with myocardial depression by anaesthetic agents. Neuraxial blockade may lead to decrease in SVR and Cardiac output. In this article we present the successful anaesthetic management of a thirty parturient suffering from Rheumatic heart disease with mitral stenosis under epidural anaesthesia with good maternal and neonatal outcome. Successful management requires vigilant perioperative monitoring and thorough knowledge of the haemodynamics of cardiac valvular disease.