Anesthetic management of a patient with Eisenmenger′s syndrome for an emergency caesarean section in an under resourced area

Abstract

Eisenmenger′s syndrome, although uncommon, has a plethora of literature available on its anesthetic management for caesarean sections. Options of management have varied from general anesthesia to continuous spinal to epidurals. However, management without the essential invasive monitoring devices poses a formidable challenge to the anesthetist. We present a case of a 26-year-old primigravida with Eisenmenger′s syndrome with pulmonary hypertension in labor who underwent an emergency cesarean section under epidural anesthesia in a hospital that lacked agents to maintain the cardiovascular stability as well as monitoring equipment - a situation not so uncommon in low resourced areas. The intra-operative course was uneventful but tragically she died on the 3 rd postoperative day.

Keywords

• Caesarean section
• Eisenmenger′s syndrome
• epidural anesthesia
• pulmonary hypertension
• under resourced area