Anesthetic management of a parturient with Ebstein anomaly posted for medical termination of pregnancy

Abstract

Abstract Pregnancy in Ebstein anomaly could cause acute decompensated heart failure. Therefore, medical termination of pregnancy is the next course of action in such cases. We present a case of 25-year-old primigravida with Ebstein anomaly posted for termination of pregnancy at 8 weeks of gestation. The patient had dyspnea on minimal exertion with a recent episode of upper respiratory tract infection. Caudal epidural in place of lumbar epidural or general anesthesia was chosen in view of the recent episode of respiratory infection and minimal hemodynamic changes and early recovery of motor blockade associated with the former. Pregnancy was terminated successfully with minimal intraoperative hemodynamics variation. Hence, for minor gynecological procedure like termination of pregnancy, caudal epidural anesthesia provides an alternative option especially in cases where hemodynamic variation is least desired like decompensating congenital heart condition.