Anaesthesia Posted By vandana Date : 14-Nov-02
I am opening a discussion for a case management I am sincerely looking forward to the replies.
The case is as follows:
A 30 yrs old female patient average height obese presented with h/o amennorhoea. She was 34 wks pregnant with valvular heart lesion MS with MR ALSO AS with AR. Her regurgitant lesions were dominant. She was a hypertensive since last 15 yrs.
She presented with leaking hence was to be taken up for c.secton. Her echo showed ejection fraction of 63% pt had absolutely no complaints except for occasional palpitation and breathlessnees on exertion.
She was managed as follows:
Sedated with 2 ml of midazolam preop pulse 92/min bp;132/86.induced with 10 mg of midazolam+inj glycoopyrrolate0.2.relaxant was vecuronium 8 mg maintained on no2 ,o2 ;50% ch+isoflurane.induction delivery time was 55 minutes. Baby was absolutely flaccid at birth and did not breath. pt was not cathetrised fluid given was 1 litre pt was reversed with atropie i,2+neostigmine2.5 pt could not maintain oxygen saturation on extubation hence was reintubated . She developed pulmonary oedema.
My question is that what went wrong and why was the baby flaccid?????