Care for the Obstetric Patient with Complex Cardiac Disease

Patrice A Vinsard; Katherine W Arendt; Emily E Sharpe

doi:10.1016/j.aan.2023.05.004

Care for the Obstetric Patient with Complex Cardiac Disease

Adv Anesth. 2023 Dec;41(1):53-69. doi: 10.1016/j.aan.2023.05.004. Epub 2023 Jul 11.

Authors

Patrice A Vinsard¹, Katherine W Arendt¹, Emily E Sharpe²

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
² Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: sharpe.emily@mayo.edu.

PMID: 38251622
DOI: 10.1016/j.aan.2023.05.004

Abstract

The prevalence of cardiac disease-related maternal morbidity and mortality is on the rise in the United States. To ensure safe management of pregnancy in patients with cardiovascular disease, pre-delivery evaluation by a multidisciplinary Pregnancy Heart Team should occur. Appropriate anesthetic, cardiac, and obstetric care are essential. Risk stratification tools evaluate the etiology and severity of cardiovascular disease to determine the appropriate hospital type and location for delivery and anesthetic management. Intrapartum hemodynamic monitoring may need to be intensified, and neuraxial analgesia and anesthesia are generally appropriate. The anesthesiologist must be prepared for obstetric and cardiac emergencies.

Keywords: Cardiac disease; Cardiovascular; Congenital heart; Neuraxial analgesia; Obstetric anesthesia; Pregnancy.

Publication types

Review

MeSH terms

Analgesia, Obstetrical / methods
Anesthetics* / administration & dosage
Female
Heart
Heart Diseases* / diagnosis
Heart Diseases* / therapy
Humans
Pregnancy
Pregnancy Complications, Cardiovascular* / diagnosis
Pregnancy Complications, Cardiovascular* / therapy

Substances

Anesthetics