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Page 22
Volume 3
Journal of Reproductive Biology and Endocrinology
WCGO2019
May 13-14 , 2019
Gynecology and Obstetrics
May 13-14 , 2019 Tokyo, Japan
2
nd
World Congress on
Successful delivery outcome with Eisenmenger syndrome in low resource setting: Arare
case report
Dalri Muhammad Suhartomo
Cipto Mangunkusumo National Hospital, Indonesia
Eisenmenger syndrome is very rare in pregnant women with an incidence of about 3%. It is rarely reported,
but it is associated with significant morbidity and mortality of both mother and baby. It is well known that
pregnancy poses an immense risk and maternal mortality reached 56% and even in recent reports mortality
rate remains unacceptably high (25-30%).
A woman, 35 years old, G3P1A1 36-37 weeks of gestational age (Her Last Menstrual Period- LMP was on
13/07/2017), singleton live head presentation, previous C-section 1 times was referred from clinic due to
absent end diastolic on doppler examination to emergency room with complaining of breathless at rest.
On examination, peripheral and central cyanosis was noted with presented clubbing finger at upper limb.
On further examination, she had a pulse 102/min, BP=127/80mm of Hg, respiratory rate=24/min, oxygen
saturation=82 % (on room air), with a raised JVP. On auscultation of the chest bilateral basal crepitations were
heard, a pansystolic murmur and loud pulmonary component of second heart sound with no ejection systolic
murmur was heard on auscultation. Hemoglobin, leucocyte hematocrit and platelet values were 20.8 g/dL,
50.9%, 5.58x103 /µL, 189x103 /µL, respectively. Arterial blood gas analysis revealed a pH 7.34, pCO2 39, pO2
68 and hCO3 21 and Base excess -4.5.
Immediately, multidisciplinary care was initiated, and consultant obstetrician was called in and cardiac and
anesthesia teams were involved in planning further care. The decision for urgent delivery was taken in view
of maternal and fetal condition and an emergency Lower Segment Cesarean Section (LSCS) continued with
tubectomy pomeron were done under epidural anesthesia with intra- arterial pressure and Central Venous
Pressure (CVP) for monitoring hemodynamic changes. The baby was reported to be doing well with no
immediate complications and was shifted to Neonatal Intensive Care Unit (NICU) Patient was shifted to
Intensive Care Unit (ICU) for post-operative care, and thromboprophylaxis post-operative day 1. She was
discharged on the eighth post-operative day.
Biography
Dalri Muhammad Suhartomo is a specialized doctor from the department of gynecology and obstetrics at the Cipto Mangunkusumo
National Hospital, Indonesia. His area of interest includes obstetrics, gynecology, delivery methods etc.
dalrimuhammadsuhartomo@gmail.comJ Reprod Biol Endocrinol, Volume 3