Combined spinal-epidural analgesia for labor and delivery in a patient with known dilated cardiomyopathy: A case report

ABSTRACT

Dilated cardiomyopathy (DCM) is a multifactorial disease with enlargement and systolic dysfunction of one or both ventricles. Most of parturients having DCM would be advised to avoid or terminate her pregnancy owing to the high risk of cardiac overload that is likely associated with pregnancy. When maternal cardiac disease is observed, effective neuraxial analgesia may play an important role because a pain induced activation of the sympathetic nervous system during labor is associated with cardiovascular adverse effects, which may endanger the maternal and/or fetal well-being. Herein we report a case of a parturient with known DCM who received combined spinal-epidural anesthesia for labor and vaginal delivery. The maternal cardiac function and the effect of analgesia were evaluated by echocardiography during labor.