[Obstructive hypertrophic cardiomyopathy and caesarean section under combined spinal and epidural anaesthesia with prophylactic vascular ligation: regarding a case]

Abstract

We report the case of a caesarean section under combined spinal and epidural anaesthesia in a pregnant 32-year-old woman with an hypertrophic obstructive cardiomyopathy. In these patients, variations of the ventricular load conditions may induce a cardiac inefficacy. In this context, the post-partum haemorrhage is a feared complication, prevent in part by oxytocine intravenously. However, its injection can be associated with haemodynamic instability, even at a low dose, and it does not spread post-partum haemorrhage. The arterial ligation according to the technique of Tsirulnikov is an alternative that we reported. This technique is followed by a good obstetrical prognosis.