Successful management of complete heart block in pregnancy

Authors

  • Rajalakshmi V. Department of Obstetrics and Gynaecology, Government RSRM Lying In Hospital, Chennai, Tamil Nadu, India
  • Shanthi K. Elango Department of Obstetrics and Gynaecology, Government RSRM Lying In Hospital, Chennai, Tamil Nadu, India
  • Priyadarsene P. Department of Obstetrics and Gynaecology, Government RSRM Lying In Hospital, Chennai, Tamil Nadu, India
  • Betty Agnes Department of Obstetrics and Gynaecology, Government RSRM Lying In Hospital, Chennai, Tamil Nadu, India
  • Sushanthini Karthik Department of Obstetrics and Gynaecology, Government RSRM Lying In Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241787

Keywords:

Complete heart block, Pacemaker, TAVB, High-risk pregnancy, Heart disease complicating pregnancy

Abstract

This case report presents a comprehensive account of effectively managing complete heart block (CHB) in a pregnant patient with prior cardiac surgery. At 36 weeks of gestation, the team opted for an elective caesarean delivery, necessitating the insertion of a temporary pacemaker. The multidisciplinary collaboration, involving obstetricians, cardiologist, and anaesthetist, played a pivotal role in ensuring a secure delivery. The report delves into the intricacies of addressing acquired CHB during pregnancy, emphasizing the scarcity of established protocols and the need for further research in this domain. Physiological changes in pregnancy, potential complications, and pacing recommendations are discussed. The success of this case underscores the significance of meticulous planning, risk stratification, and multidisciplinary approach in managing bradycardia during high-risk pregnancies. Overall, the report provides valuable insights into navigating the complexities of acquired CHB in pregnancy, advocating for enhanced screening, early recognition, and collaborative efforts among specialists.

References

Linda J. Vorvick, David C. Dugdale References: Bernstein D. History and physical examination in cardiac evaluation. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:449.

Agrawal A. Third degree Atrioventricular block (Complete heart block) Treatment and management Available at: https://emedicine.medscape.com/article/162007-treatment#d9. Accessed on 20 March 2023.

Swain S, Routray S, Behera S, Mohanty S. Pregnancy with complete heart block BMJ Case Rep. 2022;15(1):e244598.

Baghel K, Mohsin Z, Singh S, Kumar S, Ozair M, Pregnancy with Complete Heart Block. J Obstet Gynaecol India. 2016;66(Suppl 2):623-5.

Wang K, Xin J, Huang G. Pregnancy maternal fetal outcomes among pregnancies complicated with atrioventricular block. BMC Pregnancy Childbirth. 2022;22:307.

Romer AJ, Tabbutt S, Etheridge SP, Fischbach P, Ghanayem NS, Reddy VM, et al. Atrioventricular block after congenital heart surgery: Analysis from the Pediatric Cardiac Critical Care Consortium Open Archive. 2018;24.

Joglar JA, Kapa S, Saarel EV, Dubin AM, Gorenek B, Hameed AB, et al. HRS expert consensus statement on the management of arrhythmias during pregnancy. Heart Rhythm. 2023;20(10):e175-e264.

Das A, Basnet P, Shrestha R, Hada A, Bhandari B. Pregnancy with Complete Heart Block-An Emergency Cesarean Section with Temporary Pacemaker: A Case Report. JNMA J Nepal Med Assoc. 2020;58(228):597-9.

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Published

2024-06-27

Issue

Section

Case Reports