Congenital complete heart block in pregnancy is rare. Fetal distress permits no time for neuraxial blockade. Twenty-two years antenatal clinic diagnosed atrioventricular dissociation and complete heart block at 6 months of pregnancy, presented with fetal distress at 36 weeks. General anesthesia was given with transcutaneous pacemaker standby. Healthy baby was delivered. One episode of bradycardia occurred which responded to Inj atropine 0.6 mg IV however blood pressure was stable. We managed lower segment cesarean section (LSCS) in complete hearth block with fetal distress uneventfully with general anesthesia.
Perloff JK. Isolated congenital heart block. In: The clinical recognition of congenital heart disease. 5th ed., Philadelphia: Saunders; 2012. pp. 46–48.
ACC/AHA/HRS. Guidelines for device based therapy of cardiac rhythm abnormalities; 2008, ch. 2.5. pp. 367–368.
Dalvi BV, Chaudhuri A, Kulkarni HL, et al. Therapeutic guidelines for congenital complete heart block presenting in pregnancy. Obstet Gynecol 1992;79:802–404.
Kenmure AC, Cameron AJ. Congenital complete heart block in pregnancy. Br Heart J 1976;29:911–913.
Csontos CS, Bogar L, Melczer L. Temporary pacemakers for non-cardiac surgery. Eur J Anaesthesiol 2003;20:575–578. DOI: 10.1097/00003643-200307000-00014.
Hidaka N, Chiba Y, Kurita T, et al. Is intrapartum temporary pacing required for women with complete atrioventricular block? An analysis of seven cases. BJOG 2006;113(5):605–607. DOI: 10.1111/j.1471-0528.2006.00888.x.
Gambling DR, Joanne-Douglas M, McKay RSF. Obstetric Anesthesia and Uncommon Disorders; 2008. p. 33.
Modi MP, Butala B, Shah VR. Anesthesia management of unusual case of complete heart block for LSCS. Indian J Anaesth 2006;50(1): 43–44.
Umesh Kumar A, Sripriya R, Parthasarathy S, et al. Congenital complete heart block and spinal anesthesia for caesarean section. Indian J Anaesth 2012;56(1):72–74. DOI: 10.4103/0019-5049. 93350.