Perioperative management of obstetrical surgeries in women having coexisting cardiovascular disease: our experience


Methodology

Authors


  • Habib Md Reazaul Karim


    Andaman & Nicobar Island Institute of Medical Sciences and GB Pant Hospital, Port Blair. India



    http://orcid.org/0000-0002-6632-0491


  • Sairem Mangolnganbi Chanu Devi


    North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

  • Md Yunus


    North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

  • Samarjit Dey


    North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

DOI:

https://doi.org/10.7439/ijbr.v7i12.3767

Abstract

Background and aim: Coexisting cardiovascular disease in pregnancy is associated with high maternal morbidity and mortality. These patients pose a great challenge to both anesthesiologist and obstetrician. Present study was aimed at reviewing the perioperative management and outcome of obstetrical surgeries in women who had coexisting cardiovascular disease in a tertiary care teaching institute. Materials and Methods: Departmental database of all pregnant patients with coexisting cardiovascular diseases who underwent obstetrical surgeries during January 2011 to August 2016 were reviewed. Patients functional status, obstetrical history, stage of labor, type of anaesthesia, monitoring, hemodynamics, post operative care and baby outcome were noted. Data are expressed in absolute number and percentage scale and INSTAT software was used for measuring central tendencies and dispersion. Results: A total of 22 women (mean + Standard deviation: SD age 26.18 + 4.78 years) were found eligible and included for analysis. 21(95.45%) patients underwent cesarean section and one medical termination of pregnancy. 68.18% cases were done under subarachnoid block. Most of the patient needed post operative high dependant unit care, one patient developed mild pulmonary edema and no maternal and fetal deaths were noted. All the babies were born with APGAR > 7 at 1 min. No patient was managed using pulmonary artery catheter or continuous cardiac output monitoring. Conclusion: Pregnant patients with coexisting cardiovascular disease need multidisciplinary approach, timely delivery and intensive therapy in perioperative period. They can be safely delivered under subarachnoid blocks. Pulmonary artery catheterization is probably not an essential for hemodynamics management of such patients in perioperative management.

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Author Biographies

Habib Md Reazaul Karim, Andaman & Nicobar Island Institute of Medical Sciences and GB Pant Hospital, Port Blair. India

Assistant Professor. Department of Anaesthesiology.

Sairem Mangolnganbi Chanu Devi, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

Senior Resident. Department of Obstetrics & Gynecology.

Md Yunus, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

Additional Professor. Department of Anaesthesiology, Critical Care and Pain Medicine.

Samarjit Dey, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). Shillong, India.

Assistant Professor. Department of Anaesthesiology, Critical Care and Pain Medicine.

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Published

2016-12-30

How to Cite

1.
Karim HMR, Devi SMC, Yunus M, Dey S. . Int Jour of Biomed Res [Internet]. 2016Dec.30 [cited 2020Jul.5];7(12):833-7. Available from: https://ssjournals.net/index.php/ijbr/article/view/3767

Issue

Vol. 7 No. 12 (2016): Dec

Section

Original Research Articles

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