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Published on: March 21, 2013
Postural tachycardia syndrome complicating pregnancy
Cecelia A Powless1, Roger W Harms, William J Watson
1Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905,USA.
Summary
Pregnancy with postural tachycardia syndrome (POTS) is manageable. Most women with POTS can have safe vaginal deliveries, even with epidural anesthesia, contrary to previous recommendations.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Neurology
Background:
- Postural tachycardia syndrome (POTS) is a condition affecting autonomic nervous system function.
- Pregnancy in women with POTS presents unique clinical challenges and management considerations.
Purpose of the Study:
- To review clinical outcomes and management strategies for pregnancies complicated by POTS.
- To assess the safety of labor and delivery interventions in pregnant patients with POTS.
Main Methods:
- A retrospective review of nine pregnancies in seven patients diagnosed with POTS.
- Analysis of symptom exacerbations, treatment modifications, and delivery methods.
Main Results:
- Women not requiring pre-conception POTS treatment had fewer symptom exacerbations.
- Pharmacologic adjustments, like increased beta-blocker dosage, effectively managed exacerbations.
- Seven vaginal deliveries occurred, five with epidural anesthesia, without complications.
- POTS did not appear to cause pregnancy-related complications or adverse intrapartum events.
Conclusions:
- Pregnant women with POTS can safely undergo regional anesthesia and vaginal delivery.
- Findings challenge prior literature suggesting cesarean delivery as the preferred method for POTS patients.
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