Perioperative Management of a Caesarean Section in a Patient with Isolated Pulmonic Stenosis and Severe Pre-eclampsia- Learning from a Case Report

Abstract

Isolated Pulmonic Stenosis is a rare cardiac lesion leading to a right ventricular outflow tract obstruction and potentially a fixed right sided cardiac output. It is graded based on severity of stenosis and the peak pressure gradient. A thorough understanding of the dynamics of a cardiac lesion is imperative while administering an anaesthetic to such a patient. To complicate matters, concomitant pregnancy in a patient with Pulmonic Stenosis presents a challenge. Early diagnosis, increased frequency of antenatal visits as pregnancy progresses, and formulation of a plan for labour, delivery and childbirth is imperative. Avoiding cardiac decompensation, maintaining fetomaternal sufficiency and post-operative management in an enhanced maternal care setting are recommended.