DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222819
Published: 2022-10-28

Successful pregnancy outcome in a case of Eisenmenger syndrome

Tuhin S. Roy

Abstract


Eisenmenger syndrome is a very rare heart disease in pregnant women. Eisenmenger syndrome is defined as pulmonary hypertension resulting from an uncorrected left to right shunt of a VSD, ASD or patent ductus arteriosus (PDA), with subsequent shunt reversal and cyanosis. Pulmonary hypertension is the prognosis index. The high mortality risk (25-30%) is associated with pregnancy and the peripartum period due to cardiovascular collapse. Pregnancy should be discouraged and reliable contraception, preferably permanent sterilization, advised because of the extreme risk associated with pregnancy. Depo-Provera or progesterone implants are nonsurgical alternatives. Even first-trimester termination is associated with a maternal mortality rate of 5-10%. However, despite all the risks, a few patients deliver successfully with a good maternal and neonatal outcome. We presented a 27-year-old booked G1P0+0 admitted at 34 weeks gestation with Eisenmenger syndrome. She was treated medically during pregnancy, underwent elective caesarean section at 34 weeks of gestation delivered a baby and was subsequently discharged on the 15th postoperative day without any serious complications.


Keywords


Eisenmenger syndrome, Pregnancy, Pulmonary hypertension

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References


Rathod S, Samal SK. Successful pregnancy outcome in a case of Eisenmenger syndrome: a rare case report. J Clin Diagn Res. 2014;8(10):8-9.

Smith JS, Mueller J, Daniels CJ. Pulmonary arterial hypertension in the setting of pregnancy: a case series and standard approach. Lung. 2012;190(2):155-60.

Yentis SM, Steer PJ, Plaat F. Eisenmenger’s syndrome in pregnancy: maternal and fetal mortality in 1990s. Br J Obstet Gynaecol. 1998;105(8):921-2.

Vongpatanasin W, Brickner ME, Hillis LD, Lange RA. The Eisenmenger syndrome in adults. Ann Intern Med. 1998;128(9):745-55.

Yuan SM. Eisenmenger syndrome in pregnancy. Braz J Cardiovasc Surg. 2016;31(4):325-9.

Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). J Am Coll Cardiol. 2008;52(23):143-263.

Cunningham FG. Cardiovascular disorders. In: Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, eds. Williams Obstetrics; 24th ed. New York: McGraw-Hill Education; 2014: 980-90.

Kandasamy R, Koh KF, Tham SL, Reddy S. Anaesthesia for caesarean section in a patient with Eisenmenger's syndrome. Singapore Med J. 2000;41(7):356-8.

Maxwell BG, El-Sayed YY, Riely ET, Carvalho B. Peripartum outcome and anaesthetic management of parturient with moderate to complex heart disease or pulmonary hypertension. Anaesthesia. 2013;68(1):52-9.

Makaryus AN, Forouzesh A, Johnson M. Pregnancy in the patient with Eisenmenger's syndrome. Mt Sinai J Med. 2006;73(7):1033-6.

Abboud TK, Raya J, Noueihed R, Daniel J. Intrathecal Morphine for relief of labour pain in a parturient with severe pulmonary hypertension. Anesthesiology. 1983;59(5):477-9.

Kansaria JJ, Salvi VS. Eisenmenger syndrome in pregnancy. J Postgrad Med. 2000;46(2):101-3.

Drenthen W, Piper PG, Roos-Hesselink JW, Lottum WAV, Voors AA, Mulder BJM, et al. Outcome of pregnancy in women with congenital heart disease: a literature review. J Am Coll Cardiol. 2007;49(24):2303-11.