Caesarean section under continuous spinal anaesthesia in a parturient with pulmonary hypertension: A case report

Women with pulmonary hypertension have high morbidity and mortality during pregnancy. The inability to increase cardiac output can lead to heart failure, while hypercoagulability and reduced systemic vascular resistance also lead to other risks. This paper report the case of a parturient admitted for caesarean section under continuous spinal anaesthesia scheduled at 34 weeks of amenorrhea following severe pulmonary arterial hypertension. She had a history of significant mitral insufficiency. The procedure was performed without incident. The catheter was removed immediately postoperatively. The baby was female and in good health. She was transferred to the resuscitation service with restoration of oral nutrition. Loco-regional anaesthesia is to be preferred in pulmonary hypertension associated to pregnancy. In order to reduce the risk of mortality due to general anaesthesia for this type of patient, it is possible to practice the continuous spinal anaesthesia for caesarean section without having hemodynamic consequences. •The presence of pulmonary arterial hypertension in pregnant women increases the risk of morbidity and mortality.•In order to reduce the risk of mortality due to general anaesthesia, Continuous spinal anaesthesia is to be preferred in pulmonary hypertension associated to pregnancy.•This case illustrates the adapting of the anaesthetic strategy in a pregnant woman with cardiac impairment without hemodynamic consequences.