Combined spinal-epidural analgesia for labor and delivery in a patient with known dilated cardiomyopathy: A case report

Kim, Do Yeon; Park, Hyo Won; Choi, Duck Hwan

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2014;9(4):282-286.
Published online October 31, 2014.

Combined spinal-epidural analgesia for labor and delivery in a patient with known dilated cardiomyopathy: A case report

Do Yeon Kim, Hyo Won Park, Duck Hwan Choi

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. duckhwanc@gmail.com

Received: 8 January 2014 • Revised: 21 March 2014 • Accepted: 3 April 2014

Abstract

Dilated cardiomyopathy (DCM) is a multifactorial disease with enlargement and systolic dysfunction of one or both ventricles. Most of parturients having DCM would be advised to avoid or terminate her pregnancy owing to the high risk of cardiac overload that is likely associated with pregnancy. When maternal cardiac disease is observed, effective neuraxial analgesia may play an important role because a pain induced activation of the sympathetic nervous system during labor is associated with cardiovascular adverse effects, which may endanger the maternal and/or fetal well-being. Herein we report a case of a parturient with known DCM who received combined spinal-epidural anesthesia for labor and vaginal delivery. The maternal cardiac function and the effect of analgesia were evaluated by echocardiography during labor.

Key Words: Combined spinal-epidural anesthesia, Dilated cardiomyopathy, Labor