British Journal of Anaesthesia, Vol 81, Issue 5 790-792, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
R. O'Hare, C. McLoughlin, K. Milligan, D. McNamee and H. Sidhu
We describe the case of a pregnant woman, 35 weeks' gestation, with primary
pulmonary hypertension and coarctation of the aorta requiring emergency
Caesarean section under general anaesthesia. The patient had a pulmonary
artery catheter inserted before operation which revealed pulmonary artery
pressures in excess of 80/40 mm Hg. These were lowered using an infusion of
glyceryl trinitrate. After delivery of the baby and administration of
oxytocin, pulmonary artery pressures were more difficult to control. An
infusion of prostacyclin was substituted which stabilized pulmonary
pressures. After operation, she was transferred to the intensive care unit
where prostacyclin was administered by an "aerosolized" route. Her trachea
was extubated after 48 h and she made an uneventful recovery.
SHORT COMMUNICATIONS
Anaesthesia for Caesarean section in the presence of severe primary pulmonary hypertension
Department of Anaesthesia, Belfast City Hospital, Lisburn Road, Belfast BT1; Department of Obstetrics and Gynaecology, Belfast City Hospital, Lisburn Road, Belfast BT1.
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