A Rare Case Report of Pregnancy with Ventricular Septal Defect Closure and Pacemaker In Situ

Among the various congenital heart defects, a history of atrial septal defect (ASD) with ventricular septal defect (VSD) closures combined with pacemaker implantation necessitates a tailored approach to ensure maternal and fetal well-being. Here, in this case report, the patient presented with 35 weeks of pregnancy with congenital heart disease (CHD) of VSD with ASD and left-to-right shunt who had a pacemaker in situ from the year 2017. All the baseline investigations, electrocardiography, and echocardiography were done. Obstetric sonography with Doppler was done for the patient, which suggested fetal growth restriction and severe oligoamnios. The patient and the husband, with other relatives, were jointly counseled by the senior gynecologist, cardiologist, anesthetist, and neonatologist regarding all the risk factors. The patient was delivered by cesarean operation under combined spinal and epidural anesthesia. The patient had arrhythmia in the postoperative period and was managed by intravenous isoprenaline infusion and Orciprenaline tablet doses. With appropriate management, women with a history of CHD having ASD and VSD closures and pacemaker implantation can have successful pregnancies and healthy outcomes.