Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. We report a case of a successfully managed delivery in a patient with CHD.
A 29-year-old pregnant patient was admitted in Asha hospital for labor pains. On admission, she had tachycardia/ tachypnea and low blood pressure. She was a known case of CHD (Congenital heart disease).
As a high-risk pregnancy case, we explained the consequences to relatives and gave the option of shifting the patient to higher center. Patient husband refused to shift to higher center and gave have high-risk consent for emergency LSCS (Lower Segment Caesarean Section). Our team operated, baby delivered through LSCS. Post LSCS patient was shifted to ICU, the patient had severe breathlessness, desaturation, and hypotension. The patient was started on inotropes and high flow oxygen and diuretics. The patient also had an increased post-operative vaginal bleeding which made this case even more complex. Later her vaginal bleeding was managed considerably. Her blood pressure improved gradually. Pulmonary oedema subsided; diuretics and supportive treatment continued over the period of 3 days. The patient was stabilized and shifted out of ICU. This was a very high-risk case, especially with life-threatening conditions for the mother.
She had major complications post-OT stay but was managed meticulously by our ICU team, Cardiology department and our paramedical staff. Finally, the patient was discharged after 7 days of hospitalization. Both baby and mother were in good health at the time of discharge.