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Complete Heart Block in Pregnancy: A Report of Emergency Caesarean Section in a Parturient without Pacemaker.
J Clin Diagn Res. 2016 Oct; 10(10):QD01-QD02.JC

Abstract

Management of women with Complete Heart Block (CHB) presenting without pacing, during pregnancy and labour is debatable. Temporary pacemakers have been routinely inserted for labour and birth probably to withstand any haemodynamic variations. However, due to lack of large scale prospective studies, the necessity of this procedure has not been objectively assessed. Also, the most appropriate anaesthetic technique for caesarean section in women with CHB is yet to be clarified. We report herein the case of a pregnant woman with CHB who had uneventful emergency caesarean delivery under spinal anaesthesia without temporary pacing. She was an unbooked case detected with congenital CHB first time during active labour; echocardiography showed no structural cardiac disease and her heart rate increased with atropine. We suggest further research so that guidelines could be established to prevent unnecessary morbidity and expense of temporary pacemaker insertion. Newly diagnosed cases of asymptomatic CHB in late pregnancy should be worked up for chronotropic responsiveness using atropine and responsive cases may be managed without pacemaker.

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Authors+Show Affiliations

Mohapatra V
Senior Resident, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India .
Panda A
Assistant Professor, Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India .
Behera S
Senior Resident, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India .
Behera JC
Senior Resident, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India .

Pub Type(s)

Case Reports

Language

eng

PubMed ID

27891405

Citation

Mohapatra, Vandana, et al. "Complete Heart Block in Pregnancy: a Report of Emergency Caesarean Section in a Parturient Without Pacemaker." Journal of Clinical and Diagnostic Research : JCDR, vol. 10, no. 10, 2016, pp. QD01-QD02.
Mohapatra V, Panda A, Behera S, et al. Complete Heart Block in Pregnancy: A Report of Emergency Caesarean Section in a Parturient without Pacemaker. J Clin Diagn Res. 2016;10(10):QD01-QD02.
Mohapatra, V., Panda, A., Behera, S., & Behera, J. C. (2016). Complete Heart Block in Pregnancy: A Report of Emergency Caesarean Section in a Parturient without Pacemaker. Journal of Clinical and Diagnostic Research : JCDR, 10(10), QD01-QD02.
Mohapatra V, et al. Complete Heart Block in Pregnancy: a Report of Emergency Caesarean Section in a Parturient Without Pacemaker. J Clin Diagn Res. 2016;10(10):QD01-QD02. PubMed PMID: 27891405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complete Heart Block in Pregnancy: A Report of Emergency Caesarean Section in a Parturient without Pacemaker. AU - Mohapatra,Vandana, AU - Panda,Aparajita, AU - Behera,Satyanarayan, AU - Behera,Jagadish Chandra, Y1 - 2016/10/01/ PY - 2016/03/17/received PY - 2016/07/05/accepted PY - 2016/11/29/entrez PY - 2016/11/29/pubmed PY - 2016/11/29/medline KW - Haemodynamic variations KW - Maternal complete heart block KW - Temporary pacing SP - QD01 EP - QD02 JF - Journal of clinical and diagnostic research : JCDR JO - J Clin Diagn Res VL - 10 IS - 10 N2 - Management of women with Complete Heart Block (CHB) presenting without pacing, during pregnancy and labour is debatable. Temporary pacemakers have been routinely inserted for labour and birth probably to withstand any haemodynamic variations. However, due to lack of large scale prospective studies, the necessity of this procedure has not been objectively assessed. Also, the most appropriate anaesthetic technique for caesarean section in women with CHB is yet to be clarified. We report herein the case of a pregnant woman with CHB who had uneventful emergency caesarean delivery under spinal anaesthesia without temporary pacing. She was an unbooked case detected with congenital CHB first time during active labour; echocardiography showed no structural cardiac disease and her heart rate increased with atropine. We suggest further research so that guidelines could be established to prevent unnecessary morbidity and expense of temporary pacemaker insertion. Newly diagnosed cases of asymptomatic CHB in late pregnancy should be worked up for chronotropic responsiveness using atropine and responsive cases may be managed without pacemaker. SN - 2249-782X UR - https://www.unboundmedicine.com/medline/citation/27891405/Complete_Heart_Block_in_Pregnancy:_A_Report_of_Emergency_Caesarean_Section_in_a_Parturient_without_Pacemaker_ DB - PRIME DP - Unbound Medicine ER -