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Anesthesia management in pregnant women with pulmonary hypertension

underwent cesarean section under epidural anesthesia

Background: Pulmonary hypertension is a rare condition, and will increase mortality
when experienced by pregnant women. Treatment of pregnant women with
pulmonary hypertension is a challenge in anesthesia. In the report of this case will
be explained about the management of anesthesia in pregnant women with
pulmonary hypertension who underwent cesarean section operation in epidural
regional anesthesia.

Case report: 24-year-old woman diagnose with gravida 34-35 weeks with premature contractions
in the presence of pulmonary hypertension. Echocardiography obtained dilatation of the atrium
and right ventricle, severe pulmonary hypertension, moderate tricuspid regurgitation. We decided
to perform epidural regional anesthesia in these patients. Epidural block is done in a sitting
position at L3-4 with the insertion of catheters as high as T10. Awarded a total of 0.5%
bupivacaine as 18 cc. Blocks as high as T6. Babies born with Apgar score of 6-8. After the
operation is complete the patient was transferred to ICU.

Conclusion: Pulmonary hypertension in pregnancy have a high mortality rate. Epidural

anesthesia is a technique that most have minimal effects on the cardiovascular compared to
spinal or general anesthesia. Therefore this technique is the safest technique for cesarean section

Keyword : Pulmonary hypertension, epidural anesthesia, cesarean section