Peripartum cardiomyopathy and cesarean section: report of two cases and literature review.

INTRODUCTION

The anesthetic management of labor and delivery in patients with peripartum cardiomyopathy is not well defined. Using continuous spinal anesthesia with bupivacaine or combined spinal epidural anesthesia with ropivacaine in such rare clinical situations has not been previously reported.

CASE REPORT: We present two cases in which parturients with the diagnosis of peripartum cardiomyopathy presented in congestive heart failure for emergent Cesarean section. Continuous spinal anesthesia and combined spinal-epidural anesthesia were successfully employed as the anesthetic techniques for the procedures. Both patients remained hemodynamically stable during surgery and were discharged home on postoperative days 5 and 4 respectively.