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Published in: BMC Anesthesiology 1/2019

Open Access 01-12-2019 | Hypotension | Case report

Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis

Authors: Shouming Chen, Lan Wu, Xiaoqin Jiang

Published in: BMC Anesthesiology | Issue 1/2019

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Abstract

Background

Maternal cardiac arrest during cesarean section (CS) is an extremely rare but devastating complication. Preventing emergency events from developing into maternal cardiac arrest is one of the most challenging clinical scenarios.

Case presentation

A 35-year-old pregnant woman with subvalvular aortic stenosis who was scheduled for elective CS under epidural anesthesia, and experienced devastating supine hypotensive syndrome, but was successfully resuscitated after delivery.

Conclusions

The performance of tilt position strictly or high-quality continue manual left uterine displacement (LUD) should be performed until the fetus is delivered, otherwise timely delivery of the fetus may be the best way to optimize the deadly condition.
Literature
1.
go back to reference Newfeld EA, Muster AJ, Paul MH, Idriss FS, Riker WL. Discrete subvalvular aortic stenosis in childhood : study of 51 patients. Am J Cardiol. 1976;38(1):53–61.CrossRef Newfeld EA, Muster AJ, Paul MH, Idriss FS, Riker WL. Discrete subvalvular aortic stenosis in childhood : study of 51 patients. Am J Cardiol. 1976;38(1):53–61.CrossRef
2.
go back to reference Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132(18):1747.CrossRef Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132(18):1747.CrossRef
3.
go back to reference De-Giorgio F, Grassi VM, Vetrugno G, D'Aloja E, Pascali VL, Arena V. Supine hypotensive syndrome as the probable cause of both maternal and fetal death. J Forensic Sci. 2015;57(6):1646–9.CrossRef De-Giorgio F, Grassi VM, Vetrugno G, D'Aloja E, Pascali VL, Arena V. Supine hypotensive syndrome as the probable cause of both maternal and fetal death. J Forensic Sci. 2015;57(6):1646–9.CrossRef
4.
go back to reference Higuchi H, Takagi S, Zhang K, Furui I, Ozaki M. Effect of lateral tilt angle on the volume of the abdominal aorta and inferior vena cava in pregnant and nonpregnant women determined by magnetic resonance imaging. Anesthesiology. 2015;122(2):286–93.CrossRef Higuchi H, Takagi S, Zhang K, Furui I, Ozaki M. Effect of lateral tilt angle on the volume of the abdominal aorta and inferior vena cava in pregnant and nonpregnant women determined by magnetic resonance imaging. Anesthesiology. 2015;122(2):286–93.CrossRef
5.
go back to reference Tsai SE, Yeh PH, Hsu PK, Tsao SL, Chang YJ, Hsieh YJ. Continuous haemodynamic effects of left tilting and supine positions during caesarean section under spinal anaesthesia with a noninvasive cardiac output monitor system. Eur J Anaesthesiol. 2019;36(1):72–5.CrossRef Tsai SE, Yeh PH, Hsu PK, Tsao SL, Chang YJ, Hsieh YJ. Continuous haemodynamic effects of left tilting and supine positions during caesarean section under spinal anaesthesia with a noninvasive cardiac output monitor system. Eur J Anaesthesiol. 2019;36(1):72–5.CrossRef
6.
go back to reference Lyons G, Kranke P. Uterine tilt for caesarean section. Eur J Anaesthesiol. 2019;36(1):6–7.CrossRef Lyons G, Kranke P. Uterine tilt for caesarean section. Eur J Anaesthesiol. 2019;36(1):6–7.CrossRef
7.
go back to reference Einav S, Kaufman N, Sela HY. Maternal cardiac arrest and perimortem caesarean delivery: evidence or expert-based. Resuscitation. 2012;83(10):1191–200.CrossRef Einav S, Kaufman N, Sela HY. Maternal cardiac arrest and perimortem caesarean delivery: evidence or expert-based. Resuscitation. 2012;83(10):1191–200.CrossRef
Metadata
Title
Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis
Authors
Shouming Chen
Lan Wu
Xiaoqin Jiang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2019
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-019-0791-x

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