Saving both mother and child in case of rare congenital heart defect.

Can Tho City Obstetrics and Gynecology Hospital, in collaboration with Can Tho City Cardiovascular Hospital, recently successfully treated a pregnant woman with a rare congenital heart defect, Ebstein's type B, complicated by dangerous ventricular tachycardia during the final stages of pregnancy, saving the lives of both mother and child.

According to information from Can Tho City Obstetrics and Gynecology Hospital, on June 30th, the unit collaborated with Can Tho City Cardiovascular Hospital to successfully perform emergency surgery on pregnant woman LTDT (34 years old, residing in Vinh Long province) in her second pregnancy, suffering from Ebstein's congenital heart disease type B with complications of severe ventricular tachycardia.

The surgical team.

The pregnant woman was admitted to the hospital at 38 weeks and 4 days of gestation, experiencing labor pains, severe fatigue, and shortness of breath for three days. Upon examination, doctors determined the fetus was in a breech position, the uterus was contracting, and the cervix was dilated 2 cm. Notably, the woman had an elevated heart rate of 148-150 beats per minute, while also having a history of gestational diabetes.

Recognizing this as a critical case, Can Tho City Obstetrics and Gynecology Hospital promptly activated an inter-hospital consultation process involving cardiovascular specialists. Advanced echocardiography confirmed the patient had Ebstein's anomaly type B, mitral and tricuspid valve regurgitation grade 2/4, mild pulmonary hypertension, and mildly reduced left ventricular systolic function. The electrocardiogram revealed dangerous ventricular tachycardia, directly threatening the lives of both mother and fetus.

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According to Dr. Nguyen Ha Ngoc Uyen, Head of the Emergency Department, Ebstein's congenital heart disease is a rare defect of the tricuspid valve and right ventricle. In pregnant women nearing their due date, hemodynamic changes during labor can put them at risk of acute heart failure, cardiogenic shock, cardiac arrest, or pulmonary embolism at any time.

According to Dr. Uyen, treating ventricular tachycardia with intravenous medication also carries the risk of affecting the fetus. Therefore, the doctors decided to perform an emergency cesarean section immediately, while also preparing comprehensive cardiovascular resuscitation plans right in the operating room.

During surgery, the patient's ventricular arrhythmia became very complicated. The anesthesia and resuscitation team had to administer intravenous antiarrhythmic drugs and perform synchronized electrical cardioversion at 150J to restore the heart rhythm to approximately 80 beats per minute. Due to recurrent arrhythmias, the patient underwent a second electrical cardioversion combined with Amiodarone infusion and Metoprolol to control heart rate, while vital signs were continuously monitored.

Thanks to the close coordination between the obstetrics, cardiology, and anesthesiology departments, the surgery was successful. A healthy baby boy weighing 3,240 grams was born. After the surgery, the mother was transferred to the Department of Surgery, Anesthesia, Intensive Care, and Toxicology for continued monitoring and treatment.

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This case highlights the importance of women with cardiovascular disease undergoing comprehensive counseling and assessment before pregnancy. Throughout pregnancy, expectant mothers should have regular check-ups at medical facilities with specialized obstetrics and cardiology departments for close monitoring. If abnormal symptoms such as palpitations, shortness of breath, prolonged fatigue, or labor pains appear, they should immediately seek medical attention to receive timely treatment and minimize the risk of dangerous complications for both mother and fetus.

Source: https://baophapluat.vn/cuu-ca-me-va-con-ca-san-phu-mac-tim-bam-sinh-hiem-gap.html