Emergency cesarean in a patient with atrial septal defect

It is a common fact that thousands of mothers die because of pregnancy around the world each year. A comprehensive antepartum screening is of prime importance for the reduction of maternal mortality. Heart diseases are a major cause of maternal mortality. Atrial septal defect is the most common acyanotic congenital heart disease. A 22-year- old primiparous woman at 38 weeks of gestation applied to the gynecology department with palpitations and excessive fatigue. Atrial septal defect was detected in the cardiology outpatient clinic. Due to fetal distress, emergency cesarean section (C-section) was performed under spinal anesthesia. The patient developed acute -onset hypotension and respiratory distress. In this report, we present a case with Atrial septal defekt that underwent emergency C-section due to fetal distress.


1. Leary PJ, Leary SE, Stout KK, Schwartz SM, Easterling TR. Maternal, perinatal and postneonatal outcomes in women with chronic heart disease in Washington state. Obstet Gynecol 2012; 120: 1283-1290.

2. Yap SC, Drenthen W, Meijboom FJ, et al. Comparison of pregnancy outcomes in women with repaired versus unrepaired atrial septal defect. BJOG 2009; 116: 1593-1601.

3. Balint OH, Samman A, Haberer K, et al. Outcomes in patients with pulmonary hypertension undergoing percutaneous atrial septal defect closure. Heart 2008; 94: 1189-1193.

4. Saxena A, Divekar A, Soni NR. Natural history of secundum atrial septal defect revisited in the era of transcatheter closure. Indian Heart J 2005; 57: 35-38.

5. Hidano G, Uezono S, Terui K. A retrospective survey of adverse maternal and neonatal outcomes for parturients with congenital heart disease. Int J Obs Anesthesia 2011; 20: 229-235.

6. Roy R, Prasad A. Anaesthesia management of a patient with large atrial septal defect with moderate pulmonary hypertension for total abdominal hysterectomy. J Anesth Crit Care Open Access 2015; 2: 00075.

7. Akpınar O. Pregnancy and heart valve disease. Anadolu Kardiyol Derg 2009; 9: 25-34.

8. Goldszmidt E, Macarthur A, Silversides C, et al. Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery. Int J Obstet Anesth 2010; 19: 15-42.

9. Shapiro JM. Venous thromboembolism in pregnancy. J Intensive Care Med 2001; 16: 22-28.

Kaynak Göster