UNASSIGNED: A 30-year-old Para two Gravid three pregnant mother presented with chronic rheumatic heart disease, severe mitral regurgitation, moderate pulmonary hypertension, severe left atrial dilatation, mild aortic regurgitation, and mild tricuspid regurgitation scheduled for elective cesarean section. She had one previous cesarean section four years ago with an indication of fetal macrosomia. Her cardiac condition, however, was moderate mitral regurgitation, mild left atrial dilatation, mild pulmonary hypertension, and no tricuspid or aortic regurgitation. She had continuous follow-ups after diagnosis until now but has not taken any medication.
UNASSIGNED: Anaesthesia management in a patient with severe mitral regurgitation, moderate pulmonary hypertension, severe left atrial dilatation, mild aortic regurgitation, and mild tricuspid regurgitation was challenging in resource limited area. Even if spontaneous delivery is recommended for the patients with cardiac findings, a cesarean delivery will need in the area where limited access to support it. Goal-directed perioperative management with multidisciplinary involvement helps the patient to have a good outcome.
■一位30岁的Para2Gravid3孕母出现慢性风湿性心脏病,重度二尖瓣反流,中度肺动脉高压,严重的左心房扩张,轻度主动脉瓣反流,择期剖宫产术中选择轻度三尖瓣反流。四年前,她曾进行过一次剖宫产,有胎儿巨大儿的迹象。她的心脏状况,然而,中度二尖瓣反流,轻度左心房扩张,轻度肺动脉高压,无三尖瓣或主动脉瓣返流。她在诊断后一直随访到现在,但没有服用任何药物。
■严重二尖瓣反流患者的麻醉管理,中度肺动脉高压,严重的左心房扩张,轻度主动脉瓣反流,在资源有限的地区,轻度三尖瓣返流具有挑战性。即使有心脏发现的患者建议自发分娩,剖腹产需要在获得支持的地区进行。多学科参与的目标导向围手术期管理有助于患者获得良好的预后。