The incidence of complete atrioventricular block first time during pregnancy is rare. Majority of cases remain asymptomatic and do not require any active intervention. Symptomatic ones can present with syncope, dyspnea, arrhythmia, heart failure or sudden cardiac death. The risk of syncope and sudden cardiac death is increased in patients with heart rate less than 50/ minute. The goal in the perioperative anesthetic management of this case is to preserve the heart rate and maintain hemodynamic stability. We present a case of 26 years old parturient with pregnancy-induced hypertension (PIH), complete heart block (CHB), intrauterine growth retardation (IUGR), and Rh incompatibility managed under spinal anesthesia.
Suri V, Keepanasseril A, Aggarwal N, et al. Maternal complete heart block in pregnancy: analysis of four cases and review of management. J Obstet Gynaecol Res. 2009;35(3):434-437.
Vukomanovic V, Stajevic M, Kosutic J, et al. Age-related role of ambulatory electro cardiographic monitoring in risk stratification of patients with the complete congenital atrioventricular block. Europace 2007;9:88-93.
Kumar AU, Sripriya R, Parthasarathy S, et al. Congenital complete heart block and spinal anaesthesia for caesarean section. Indian J Anaesth 2012;56(1):72-74.
Hidaka N, Chiba Y, Fukushima K, et al. Pregnant women with complete atrioventricular block: perinatal risks and review of management. Pacing Clin Electrophysiol 2011; 34(9):1161-1176.
Thaman R, Curtis S, Faganello G, et al. Cardiac outcome of pregnancy in women with a pacemaker and women with untreated atrioventricular conduction block. Europace 2011;13:859-863.
Hidaka N, Chiba Y, Kurita T, et al. Is intrapartum temporary pacing required for women with complete atrioventricular block? An analysis of seven cases. Int J Obstet Gynaecol 2006;113:605-607.
López Ayerbe J, Villuendas Sabaté R, García García C, et al. Temporary pacemakers: current use and complications. Rev Esp Cardiol 2004;57:1045-1052.