Case Report

Perioperative Hemodynamic Management in Pregnancy with Aortic coarctation Undergoing Cesarean Delivery Under General Anesthesia: A Case Report

Abstract

Aortic coarctation represents a complex challenge during pregnancy due to altered cardiovascular physiology. We describe the successful perioperative management of a 24-year-old primigravida at 32 weeks of gestation with unrepaired coarctation of the aorta undergoing elective cesarean section. The patient presented with significant hypertension (upper limb 140-150/100 mmHg versus lower limb 90-100/70 mmHg) and dyspnea. Intraoperative management included dual invasive arterial line placement for continuous hemodynamic assessment, general anesthesia with careful titration of intravenous nitroglycerin (1 mL/hour), and thoughtful fluid administration resulting in a positive balance of 500 mL. Postoperative blood gas analysis demonstrated normal acid-base parameters. This case underscores the necessity for multidisciplinary coordination, invasive hemodynamic monitoring, and meticulous pharmacological intervention in high-risk cardiac pregnancies.

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Keywords
Aortic Coarctation Pregnancy Hemodynamic Monitoring General Anesthesia Nitroglycerin
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How to Cite
1.
Khatri S, Reddy Kishan Reddy C, Hasnain S. Perioperative Hemodynamic Management in Pregnancy with Aortic coarctation Undergoing Cesarean Delivery Under General Anesthesia: A Case Report. Arch Anesth & Crit Care. 2026;.