Open AccessVaginal delivery in a case of mitral stenosis: Sevoflurane to the rescue
Author(s) -
Atchya Arun Kumar,
Vishal Krishna Pai,
Anil Kumar Singh,
Mridul Dhar
Publication year - 2017
Publication title -
yīxué yánjiū zázhì/journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 12
eISSN - 2542-4939
pISSN - 1011-4564
DOI - 10.4103/1011-4564.200739
Subject(s) - medicine , pregnancy , vaginal delivery , valvular heart disease , stenosis , intensive care medicine , heart disease , disease , surgery , cardiology , genetics , biology
Rheumatic heart disease is the most common cardiac disease associated with pregnancy in developing countries. In India, rheumatic mitral stenosis (MS) comprises 88% of heart diseases complicating pregnancy. Despite advances and improved anesthetic techniques, the management of parturients with cardiac valvular pathology can be challenging. Therefore, the anesthesiologist has to be vigilant and meticulous in planning the technique of anesthesia to aid in safe confinement. In this article, we present the anesthetic management of a parturient who presented to our hospital with a medical record of moderate MS, in active labor. We combined a technique most feasible at that moment, with tactful and detailed knowledge of the pathophysiology to guide our anesthetic management and facilitate a normal vaginal delivery. We have tried to highlight how clinically individualized and personalized care with sound pathophysiological knowledge of the patient's cardiac condition can achieve optimal outcomes, especially when conventional modes and techniques are not feasible