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Cesarean Section With Eisenmenger Syndrome

Primi gravida 21 years of age with twin pregnancy of 33 weeks with Eisenmenger syndrome was operated under combined spinal epidural on 22/8/17 by Dr Shallu Kakkar, Additional Director OBGYN La Femme, and Jaipur.
Patient was diagnosed as heart disease at 2 month of age. Patient took treatment at Shah Jahanpur till 1 year of age. She was ASYMPTOMATIC till 5 months of her pregnancy, when she was diagnosed again- Pregnancy with heart disease (Eisenmenger’s syndrome). She took treatment from cardiologist and consulted a gynaecologist as well.
Eisenmenger’s syndrome includes any condition in which a communication between the systemic and pulmonary circulations gives rise to pulmonary vascular disease, which in turn causes a right to left shunt with pulmonary hypertension. It is a rare condition that poses a significant risk of maternal death.
After LSCS, she was managed under close observation in ICU for 2 days and shifted to ward on 3rd day. Cardiologist review was taken and i.v antibiotics, i.v. fluids, Inj Lasix was given with oxygen inhalation, steam inhalation and nebulization. All supportive management was given and patient got discharged on 25.8.17 in a satisfactory condition.
The twins were with a weight of 1.5 Kgs and 1.8 Kgs respectively with one twin having breathing difficulty and was given CPAP support from delivery room itself. Both the babies recovered well and went home by day 3 itself.

Dr Shallu Kakkar
MS (Gynaecology & Obstetrics)
Addl. Director,
Dept of Obstetrics and Gynaecology,
La Femme Jaipur

Dr Satyen K Hemrajani

Baby of XYZ was born to an elderly (57 years old) mother by IVF conception with twins’ pregnancy initially of which only one survived (IUFD). Baby was born by elective LSCS and needed positive pressure ventilation and early CPAP support for initial respiratory distress. Baby had a weight of 1.186 Kgs at 30 weeks. After initial surfactant instillation, baby was rapidly extubated on day 1 of life itself and started on parenteral nutrition and antibiotics. Despite problem of multiple episode of apnea (cessation of breathing effort) and feed intolerance the baby came out unscathed with no chronic sequelae of prematurity and was discharged after 31 days of NICU stay at a weight of  >1.5 kg in a healthy state.

Dr Satyen K Hemrajani,
DNB (Neonatology)
Sr. Consultant,
Dept of Neonatology,
La Femme Jaipur

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