Acute myocardial infarction rarely occurs in women during childbearing age (1:20,000), but maternal mortality rate is high (11%). Management of pregnant woman affected by myocardial infarction could be a challenge for obstetricians, cardiologists and anesthetists. In this report, we present the management of a 36 years-old nulliparous woman affected from hypertension and dyslipidemia, who experienced acute myocardial infarction at 25th gestational week and was scheduled for caesarean delivery at 35th week. General anesthesia for cesarean section was conducted using sevoflurane and remifentanil target controlled infusion (TCI); the patient was monitored with ECG, pulse oximetry, invasive blood pressure, haemodynamic measurement by lithium dilution cardiac output (LiDCO plus) and bispectral index. The titrated use of remifentanil and the close control of hemodynamic parameters by LiDCO plus monitoring may contribute to improve maternal outcome and newborn well-being in the management of general anesthesia for caesarean section.

Frassanito, L., Vagnoni, S., Zanfini, B. A., Catarci, S., Maggiore, S. M., Draisci, G., General anesthesia for caesarean delivery in a pregnant woman affected by acute myocardial infarction, <<EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES>>, 2012; 16 (Agosto): 1123-1126 [http://hdl.handle.net/10807/51462]

General anesthesia for caesarean delivery in a pregnant woman affected by acute myocardial infarction

Frassanito, Luciano;Vagnoni, Salvatore;Zanfini, Bruno Antonio;Catarci, Stefano;Maggiore, Salvatore Maurizio;Draisci, Gaetano
2012

Abstract

Acute myocardial infarction rarely occurs in women during childbearing age (1:20,000), but maternal mortality rate is high (11%). Management of pregnant woman affected by myocardial infarction could be a challenge for obstetricians, cardiologists and anesthetists. In this report, we present the management of a 36 years-old nulliparous woman affected from hypertension and dyslipidemia, who experienced acute myocardial infarction at 25th gestational week and was scheduled for caesarean delivery at 35th week. General anesthesia for cesarean section was conducted using sevoflurane and remifentanil target controlled infusion (TCI); the patient was monitored with ECG, pulse oximetry, invasive blood pressure, haemodynamic measurement by lithium dilution cardiac output (LiDCO plus) and bispectral index. The titrated use of remifentanil and the close control of hemodynamic parameters by LiDCO plus monitoring may contribute to improve maternal outcome and newborn well-being in the management of general anesthesia for caesarean section.
Inglese
Frassanito, L., Vagnoni, S., Zanfini, B. A., Catarci, S., Maggiore, S. M., Draisci, G., General anesthesia for caesarean delivery in a pregnant woman affected by acute myocardial infarction, <<EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES>>, 2012; 16 (Agosto): 1123-1126 [http://hdl.handle.net/10807/51462]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/51462
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