CONTINOUS SPINAL ANAESTHESIA FOR LSCS IN PARTURIENTS WITH DILATED CARDIOMYOPATHY AND LOW EJECTION FRACTION

Rajmala Jaiswal; Susheela Taxak; Ashwani kumar; Nikhil Guliyani

Volume : VII, Issue : XI, November - 2018

CONTINOUS SPINAL ANAESTHESIA FOR LSCS IN PARTURIENTS WITH DILATED CARDIOMYOPATHY AND LOW EJECTION FRACTION

Rajmala Jaiswal, Susheela Taxak, Ashwani Kumar, Nikhil Guliyani

Abstract :

Parturients with cardiac conditions have risk to life during normal vaginal delivery hence elective LSCS under anaessthesia has been reported to reduce the risk to life of mother and safe delivery of foetus. Severe ventricular dysfunction occurs in peripartum cardiomyopathy during late pregnancy or early puerperium. Peripartum cardiomyopathy is associated with decreased ejection fraction in late pregnancy or early puerperium. Normal value of ejection fraction (EF) ranges from 55% – 70%. Patients with EF < 35% ( low EF ) are at risk of arrhythmias leading to sudden cardiac arrest and death. Intensive cardiac management is required in these patients along with anaesthetic interventions for painless labour and delivery either vaginal or operative. Maternal and neonatal mortality and morbidity can be reduced by highly skilled perioperative anaesthetic management. Here we present a case of 28 year old primigravida with dilated CMP and EF 20% was managed using continuous spinal anaesthesia for LSCS. Both the haemodynamic stability and outcome of mother and fetus is satisfactory with this type of anaesthesia.