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Horiuchi T, Takeda S, Mieda R, Hiroki T, Saito S. Anesthesia management for cesarean section in a woman with chronic renal failure and heart failure: a case report. J Med Case Rep 2024; 18:355. [PMID: 39098903 PMCID: PMC11299372 DOI: 10.1186/s13256-024-04694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 07/10/2024] [Indexed: 08/06/2024] Open
Abstract
INTRODUCTION Pregnancy in a woman with heart and chronic renal failure can lead to life-threatening complications for both mother and child. Although such cases are often delivered by cesarean section, few reports have described anesthesia methods. CASE PRESENTATION We encountered a case in which cesarean section was performed using combined spinal and epidural anesthesia for a pregnant woman with chronic renal and heart failure. The 35-year-old Japanese woman had been undergoing hemodialysis for several years. Heart failure symptoms that appeared during pregnancy initially improved with treatments such as increasing hemodialysis, but recurred. She was admitted to the intensive care unit. The initial plan was to deliver the baby after a few weeks, but further progression of heart failure became a concern. After a clinical conference among staff, a cesarean section with combined spinal and epidural anesthesia was scheduled for 24 weeks, 0 days of gestation. The anticoagulant for dialysis was also changed from heparin to nafamostat in preparation for cesarean section. Monitoring was started with central venous and radial artery pressures before induction of anesthesia. Combined spinal and epidural anesthesia was induced and the cesarean section was completed without complications. Surgery was initiated under continuous administration of phenylephrine, which was intended to avoid hypotension due to anesthesia. The hemodynamic and respiratory status of the patient remained stable postoperatively. After the cesarean section, morphine was administered epidurally and the epidural catheter was removed. CONCLUSION Cesarean section was safely performed for a pregnant woman with renal and heart failure using combined spinal and epidural anesthesia.
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Affiliation(s)
- Tatsuo Horiuchi
- Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
| | - Syunsuke Takeda
- Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Rie Mieda
- Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Tadanao Hiroki
- Department of Anesthesiology, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki, Gunma, 372-0817, Japan
| | - Shigeru Saito
- Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
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胡 家, 张 建. [High-flow nasal oxygen versus conventional oxygen therapy during cesarean section under neuraxial anesthesia in pregnant women with heart disease: a randomized controlled trial]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2024; 44:1040-1047. [PMID: 38977333 PMCID: PMC11237303 DOI: 10.12122/j.issn.1673-4254.2024.06.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Indexed: 07/10/2024]
Abstract
OBJECTIVE To evaluate the beneficial effects of high-flow nasal cannula (HFNC) oxygen therapy during cesarean section in pregnant women with heart disease. METHODS We conducted a single-center, single-blinded randomized trial of HFNC oxygen therapy in pregnant women with heart disease undergoing cesarean section under neuraxial anesthesia.The participants were randomly assigned to receive either HFNC oxygen therapy with inspiratory flow of 30 L/min with 40% FIO2(n=27) or conventional oxygen therapy (COT) with oxygen flow rate of 5 L/min via a nasal cannula (n=31).The primary outcome was maternal desaturation (SpO2 < 94% lasting more than 3 min or PaO2/FIO2≤300 mmHg). RESULTS Maternal desaturation was observed in 7.4%(2/27) of the women in HFNC group and in 32.3%(10/31) in the COT group.None of the cases required tracheal intubation during the perioperative period.The HFNC group had a significantly higher incidence of postoperative leukocytosis (P < 0.05) but without pyrexia or other inflammation-related symptoms.There were no significant differences between the two groups in the secondary maternal outcomes (need for respiratory support, maternal ICU admission, postoperative respiratory complications, and cardiovascular complications) or neonatal outcomes (P>0.05). CONCLUSION In pregnant women with heart disease, HFNC therapy can significantly reduce the rate of maternal desaturation during the perioperative period of cesarean section without adverse effects on short-term maternal or fetal outcomes.
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Rakisheva A, Sliwa K, Bauersachs J, Van Linthout S, Chopra VK, Bayes-Genis A, Fruzzetti F, Cannatà A, Deniau B, Mebazaa A, Savarese G, Ray R, Vitale C, Metra M, Rosano GMC. Multidisciplinary care of peripartum heart failure: A scientific statement of the Heart Failure Association of the ESC. Eur J Heart Fail 2024; 26:742-753. [PMID: 38679896 DOI: 10.1002/ejhf.3246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/22/2024] [Accepted: 04/04/2024] [Indexed: 05/01/2024] Open
Abstract
Heart failure is the most common cardiovascular complication during pregnancy and the postpartum period. It is associated with increased risk of maternal morbidity and mortality as well as potentially life-threatening foetal pathology. Management of heart failure in pregnancy requires expert knowledge of cardiovascular disease as well as obstetrics which underscores the importance of multidisciplinary cardio-obstetrics teams in order to optimize diagnosis, treatment and outcome. This includes counselling of women at risk before and during the course of pregnancy in order to strengthen the relationship between medical specialists and patients, as well as to allow patient-centred delivery of care and improve quality of life.
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Affiliation(s)
- Amina Rakisheva
- Department of Cardiology, City Cardiology Center, Almaty, Kazakhstan
- Qonaev City Hospital, Almaty, Kazakhstan
| | - Karen Sliwa
- Cape Heart Institute, Department of Cardiology and Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Sophie Van Linthout
- Berlin Institute of Health (BIH) at Charité - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Berlin, Berlin, Germany
| | | | - Antoni Bayes-Genis
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Franca Fruzzetti
- Department of Obstetrics and Gynecology, Pisa University Hospital, Pisa, Italy
| | - Antonio Cannatà
- King's College London, British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | - Benjamin Deniau
- Department of Anesthesiology, Critical Care and Burn Unit, University Hospital Saint-Louis - Lariboisière, AP-HP, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Université de Paris Cité, Paris, France
- FHU PROMICE, DMU Parabol, Paris, France
| | - Alexandre Mebazaa
- Department of Anesthesiology, Critical Care and Burn Unit, University Hospital Saint-Louis - Lariboisière, AP-HP, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Université de Paris Cité, Paris, France
- FHU PROMICE, DMU Parabol, Paris, France
| | - Gianluigi Savarese
- Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Robin Ray
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's, University of London, St George's Hospital, London, UK
| | - Cristiana Vitale
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's, University of London, St George's Hospital, London, UK
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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Lau ES, Aggarwal NR, Briller JE, Crousillat DR, Economy KE, Harrington CM, Lindley KJ, Malhamé I, Mattina DJ, Meng ML, Mohammed SF, Quesada O, Scott NS. Recommendations for the Management of High-Risk Cardiac Delivery: ACC Cardiovascular Disease in Women Committee Panel. JACC. ADVANCES 2024; 3:100901. [PMID: 38939671 PMCID: PMC11198580 DOI: 10.1016/j.jacadv.2024.100901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/28/2023] [Accepted: 01/30/2024] [Indexed: 06/29/2024]
Abstract
Maternal mortality is a major public health crisis in the United States. Cardiovascular disease (CVD) is a leading cause of maternal mortality and morbidity. Labor and delivery is a vulnerable time for pregnant individuals with CVD but there is significant heterogeneity in the management of labor and delivery in high-risk patients due in part to paucity of high-quality randomized data. The authors have convened a multidisciplinary panel of cardio-obstetrics experts including cardiologists, obstetricians and maternal fetal medicine physicians, critical care physicians, and anesthesiologists to provide a practical approach to the management of labor and delivery in high-risk individuals with CVD. This expert panel will review key elements of management from mode, timing, and location of delivery to use of invasive monitoring, cardiac devices, and mechanical circulatory support.
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Affiliation(s)
- Emily S. Lau
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Niti R. Aggarwal
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
| | - Joan E. Briller
- Division of Cardiology, Department of Medicine, Obstetrics, and Gynecology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Daniela R. Crousillat
- Division of Cardiovascular Sciences, Department of Medicine, Obstetrics, and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Katherine E. Economy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Colleen M. Harrington
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kathryn J. Lindley
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Isabelle Malhamé
- Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Deirdre J. Mattina
- Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marie-Louise Meng
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Selma F. Mohammed
- Division of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, USA
| | - Odayme Quesada
- Women’s Heart Center, The Carl and Edyth Lindner Center for Research & Education, The Christ Hospital Network Heart & Vascular Institute, Cincinnati, Ohio, USA
| | - Nandita S. Scott
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - ACC Cardiovascular Disease in Women Committee
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
- Division of Cardiology, Department of Medicine, Obstetrics, and Gynecology, University of Illinois Chicago, Chicago, Illinois, USA
- Division of Cardiovascular Sciences, Department of Medicine, Obstetrics, and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
- Division of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, USA
- Women’s Heart Center, The Carl and Edyth Lindner Center for Research & Education, The Christ Hospital Network Heart & Vascular Institute, Cincinnati, Ohio, USA
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Meng ML, Arendt KW, Banayan JM, Bradley EA, Vaught AJ, Hameed AB, Harris J, Bryner B, Mehta LS. Anesthetic Care of the Pregnant Patient With Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2023; 147:e657-e673. [PMID: 36780370 DOI: 10.1161/cir.0000000000001121] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The pregnancy-related mortality rate in the United States is excessively high. The American Heart Association is dedicated to fighting heart disease and recognizes that cardiovascular disease, preexisting or acquired during pregnancy, is the leading cause of maternal mortality in the United States. Comprehensive scientific statements from cardiology and obstetrics experts guide the treatment of cardio-obstetric patients before, during, and after pregnancy. This scientific statement aims to highlight the role of specialized cardio-obstetric anesthesiology care, presenting a systematic approach to the care of these patients from the anesthesiology perspective. The anesthesiologist is a critical part of the pregnancy heart team as the perioperative physician who is trained to prevent or promptly recognize and treat patients with peripartum cardiovascular decompensation. Maternal morbidity is attenuated with expert anesthesiology peripartum care, which includes the management of neuraxial anesthesia, inotrope and vasopressor support, transthoracic echocardiography, optimization of delivery location, and consideration of advanced critical care and mechanical support when needed. Standardizing the anesthesiology approach to patients with high peripartum cardiovascular risk and ensuring that cardio-obstetrics patients have access to the appropriate care team, facilities, and advanced cardiovascular therapies will contribute to improving peripartum morbidity and mortality.
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Muacevic A, Adler JR, Varvarousi G, Loukeri A, Valsamidis D. The Use of Vigileo® Monitor in a Parturient With Severe Mitral Valve Stenosis and Severe Pulmonary Hypertension Undergoing Cesarean Section Under General Anesthesia: A Case Report and Literature Review. Cureus 2022; 14:e32284. [PMID: 36627983 PMCID: PMC9822533 DOI: 10.7759/cureus.32284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/12/2022] Open
Abstract
We report a case of a 35-year-old pregnant female of Afghan origin who was admitted to the intensive care unit (ICU) because of pulmonary edema development when she was in the 30th week of gestation. During the bedside examination, the transthoracic echocardiogram (TTE) revealed severe mitral valve stenosis and pulmonary hypertension. The patient went into treatment with metoprolol for the control of tachycardia and furosemide for the prevention of fluid overload. During the 32nd week of gestation, the medical council decided on a cesarean section (CS) to be carried out under general anesthesia. The anesthesiologists decided to use the Vigileo monitor (Edwards Lifesciences, Irvine, CA, USA) as it is vitally important to approach fluid administration as fluid management is challenging concerning the obstetric patient. Vigileo monitoring is based on the invasive measurement of cardiac output (CO), cardiac index (CI), stroke volume (SV), and stroke volume variation (SVV). Fluid resuscitation based on hemodynamic parameters is a key component of patient care, especially in scenarios such as cardiovascular disease. This is the first case report where a Vigileo monitor was applied to a patient with severe mitral valve stenosis and severe pulmonary hypertension undergoing a cesarean section, which was accomplished without any complications. The patient was discharged from the hospital on the 12th postoperative day, hemodynamically stable. Each immigrant woman, regardless of her financial, social, cultural, or any other situation, has the fundamental right to receive complete perinatal healthcare. Nevertheless, the most recent statistical data show that those women's access to public healthcare is insufficient, leading to high rates of maternal mortality. The international medical community has to adapt to the new multicultural environment, and health services must be provided to this vulnerable population with the appropriate level of safety.
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Sun P, Liang XQ, Hong T, Zhang H. Perioperative management of acute myocardial infarction in the 31st week of pregnancy: A case report and literature review. Front Surg 2022; 9:1023551. [DOI: 10.3389/fsurg.2022.1023551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
Pregnancy-related acute myocardial infarction (PAMI) is rare but life-threatening. The incidence of PAMI is growing over time for multiple reasons, and the management of parturients with acute myocardial infarction is challenging in terms of diagnosis and treatment. To date, there are still no clear guidelines on the best practice for PAMI. We present a case of a 41-year-old woman with PAMI at 31 weeks of pregnancy. Through multidisciplinary collaboration, successful outcomes were achieved for both the mother and fetus.
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Sonnino C, Frassanito L, Zanfini BA, Catarci S, Olivieri C, Ciancia M, Santantonio MT, Draisci G. A Case of Multidisciplinary Approach to Post-Radiotherapy Dilative Cardiomyopathy Undergoing Elective Cesarean Delivery: Anesthetic and Intensive Care Management. CARDIOLOGY AND CARDIOVASCULAR MEDICINE 2022; 6:493-496. [PMID: 36380984 PMCID: PMC9648409 DOI: 10.26502/fccm.92920288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cardiovascular diseases are the most common non-obstetric cause of maternal death. These cases became more common thanks to the improvement in cardiovascular therapies. A multidisciplinary team is necessary to manage these pregnancies. CASE REPORT A 32 years old women at the 25th week of gestation for acute heart failure in pre-existing left ventricular dysfunction induced by radio-chemotherapy admitted to the Coronary Unit of IRCCS Policlinico Universitario Agostino Gemelli for worsening of dyspneic symptoms and anuria not responding to diuretic therapy. At the echocardiogram: ejection fraction 30%, enlarged left atrium, systolic pulmonary arterial pressure 38 mmHg, bilateral pleural effusion, bilateral diffused pulmonary B lines. A multidisciplinary team composed by cardiologists, gynecologists, anesthesiologists, cardiac surgeons, neonatologists and bioethicists decided for an elective cesarean delivery at the 27th week of gestation in the hybrid cardio-thoracic operating theater. Anesthesia was provided by combined spinal-epidural technique under invasive continuous hemodynamic monitoring with the Edwards Lifesciences HemoSphere with Hypotension Prediction Index (HPI) and ForeSight technology (Edwards Lifesciences, Irvine, USA) through catheterization of the left radial artery. The femoral arteries were left available for extracorporeal circulation. Continuous norepinephrine infusion was started once liquor was collected in the spinal needle at a 0.1 mcg/kg/minute through a central line and was continued until the end of surgery. Fluid management consisted of a total of 200 ml of crystalloids. HPI values never reached alarm values (maximum value =10). The patient was discharged home on the 5th day after delivery with good hemodynamic compensation. The baby was intubated at birth and then gradually weaned from mechanical ventilation, then discharged.
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Affiliation(s)
- Chiara Sonnino
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Luciano Frassanito
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Bruno Antonio Zanfini
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Stefano Catarci
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Cristina Olivieri
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Mariano Ciancia
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Maria Teresa Santantonio
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
| | - Gaetano Draisci
- Unit of Obstetric and Gynecologic Anesthesia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Italy
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Liao H, Hu Q, Deng C, Wang X, Yu H. Maternal and Neonatal Outcomes in Pregnancy Complicated with Pulmonary Hypertension. Rev Cardiovasc Med 2022; 23:172. [PMID: 39077608 PMCID: PMC11273753 DOI: 10.31083/j.rcm2305172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 07/31/2024] Open
Abstract
Background Pulmonary hypertension (PH) is a life-threatening disease with significant maternal morbidity and mortality. Methods To assess pregnancy and neonatal outcomes and determine the risk factors for adverse maternal and neonatal outcomes in women with pulmonary hypertension (PH), a retrospective analysis was carried out examining 71 pregnancies in patients with PH who delivered at a tertiary care center in West China between January 2011 and May 2016. Results One pregnancy resulted in spontaneous abortion and six resulted in terminated abortions. Cardiac complications were encountered in 16.9% including three maternal mortalities. At least one pregnancy complication occurred in 28.2% of all the pregnancies. Diagnosis after the third trimester, severe PH and/or right ventricular systolic dysfunction were predictive of adverse fetal/neonatal events. A history of prior cardiac events and right ventricular systolic dysfunction and/or baseline New York Heart Association (NYHA) class III or IV were the main predictive factors of adverse maternal cardiac events. Conclusions In our study, we found that PH poses high risks for maternal and fetal morbidity and mortality. A detailed pre-pregnancy baseline assessment is strongly recommended in women with PH to identify those with the highest risk and subsequently guide clinical management.
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Affiliation(s)
- Hua Liao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China
| | - Qing Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China
| | - Chunyan Deng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China
| | - Xiaodong Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China
| | - Haiyan Yu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China
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Odendaal PS, Burke JL. Case report of a caesarean delivery in a primigravida with congenitally corrected transposition of the great arteries. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2022. [DOI: 10.36303/sajaa.2022.28.2.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- PS Odendaal
- Department of Anaesthesiology and Critical Care, Stellenbosch University,
South Africa
| | - JL Burke
- Department of Anaesthesiology and Critical Care, Stellenbosch University,
South Africa
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