Balancing Maternal Cardiac Risk and Anaesthetic Safety: A Case Series on Segmental Spinal Anaesthesia

Pregnancy evokes significant alterations to the physiologic conditions in females and it is more dramatic for women suffering from valvular heart diseases or congenital cardiovascular diseases. Increases in blood volume and cardiac output, as well as the tendency for decreases in systemic vascular resistance, can augment and worsen underlying disease and make anaesthesia for delivery and labour more complicated. In the management of cardiovascular diseases in women, a tailored, multidisciplinary approach can ensure the best outcome for both mothers and neonates. The present case series reports the application of Segmental Spinal Anaesthesia (SSA) in pregnant women suffering from complex cardiac conditions who require a caesarean section. The use of SSA has been recognised to minimise haemodynamic changes compared to spinal anaesthesia. By providing a regional block to select portions of the spinal cord, SSA mitigates hypotension and does not suffer from the sympathetic blockade that is readily seen in a traditional spinal anaesthetic. The present case series underscores the importance of individualised anaesthetic planning, holistic assessment of patients and multidisciplinary collaboration among obstetricians, anaesthetists and cardiologists.The findings suggest that SSA can be a safe and effective anaesthetic technique for high-risk obstetricpatients, particularly those with cardiovascular diseases, thereby providing a promising alternative togeneral anaesthesia or conventional spinal techniques for caesarean sections.