[Epidural anesthesia for cesarean section in a patient with Eisenmenger's syndrome]

A case of a 21 year old pregnant patient with a Eisenmenger's syndrome is reported. She was in her 38th weeks of pregnancy and submitted to a cesarean section under epidural anaesthesia. In spite of a FiO2 1 administered through a nonrebreathing mask, she presented refractory hypoxemia. Hypotension during delivering was observed and treated with sympathomimetic drugs. Four days later, the patient presented a pulmonary thromboembolic clinical phenomena and died. Eisenmenger's syndrome during pregnancy is reviewed. Maternal mortality rate is higher in cesarean section (75%) when compared with vaginal delivery. We conclude that epidural anaesthesia can be an useful technique for these patients under a careful hemodynamic management and a proper dose of local anaesthetics.