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Canadian Journal of Anaesthesia

, Volume 37, Issue 4, pp 469–473 | Cite as

Pulmonary oedema in two parturients with hypertrophic obstructive cardiomyopathy (HOCM)

  • Michael J. Tessler
  • Robert Hudson
  • MaryAnne Naugler-Colville
  • Diane R. Biehl
Clinical Reports

Abstract

Two patients with hypertrophic obstructive cardiomyopathy (HOCM) presented for delivery. The first had a repeat Caesarean section with general anaesthesia and the second gave birth vaginally with epidural analgesia. Both patients developed pulmonary oedema in the peripartum period. These cases highlight the delicate fluid requirements of the pregnant patient with HOCM. The fluid management of the parturient is discussed with particular emphasis on the pathophysiology of HOCM. The indications for invasive monitoring are presented.

Key Words

Anaesthesia: obstetric Complications: pulmonary oedema Heart: cardiomyopathy, hypertrophic obstructive 

Résumé

Deux patientes atteintes de cardiomyopathie hypertrophique obstructive (HOCM) se sont présentées pour accouchement. La première se présentait pour une seconde césarienne sous anesthésie générale alors que la seconde accoucha par voie naturelle sous épidurale. Les deux patientes ont développé de l’oedème pulmonaire lors de l’accouchement. Ces cas démontrent la fragilité de l’équilibre hydrique chez les patientes enceintes atteintes de HOCM. La conduite à faire dans des cas pareils est discutée en mettant l’emphase sur la pathophysiologie de l’HOCM. Les indications pour une surveillance par des techniques invasives sont présentées.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Michael J. Tessler
    • 1
  • Robert Hudson
    • 1
  • MaryAnne Naugler-Colville
    • 1
  • Diane R. Biehl
    • 1
  1. 1.Department of AnaesthesiaSt. Boniface General HospitalWinnipeg

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