Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-18T08:44:04.194Z Has data issue: false hasContentIssue false

Chapter 4 - Challenging Cardiac Disorders in Pregnancy

Published online by Cambridge University Press:  26 January 2024

By
Hanna Hussey ,
Patrick Hussey  and
Marie-Louise Meng
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Grace Lim
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Grace Lim
Affiliation:
University of Pittsburgh
Get access

Summary

Cardiovascular disease (>25%) is the leading cause of death among pregnant women in the United States. This chapter covers risk stratification, pathophysiology, and anesthetic management of women with specific cardiac diseases. In the last decade, advances in treatment and management of cardiac disease in the pregnant patient have led to improvements in survival of obstetric patients with known cardiac disease. Key to the improvements in care is the creation of Pregnancy Heart Teams, multidisciplinary teams with knowledge and experience caring for the obstetric patient with cardiovascular disease. Cardiovascular disease encompasses a heterogeneous group of lesions with differing hemodynamic goals, management and risks during pregnancy, delivery, and postpartum. The anesthesiologist is best able to care for these women by understanding the specific cardiovascular lesion, a woman’s current status, the obstetric and fetal considerations and the impact of anesthetic techniques.

Keywords

cardiovascular diseaserisk stratificationperipartum cardiomyopathyvalvular diseasepregnancy heart teamcongenital heart diseasecardiac assist devicesanticoagulationneuraxial anesthesia
Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 25 - 46
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System 2020. Available from: www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm#causes [last accessed August 31, 2022].Google Scholar
Thompson, JL, Kuklina, EV, Bateman, BT, et al. Medical and obstetric outcomes among pregnant women with congenital heart disease. Obstet Gynecol 2015;126:346–354.Google Scholar
Regitz-Zagrosek, V, Blomstrom Lundqvist, C, Borghi J, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J 2011;32:3147–3197.Google Scholar
Mehta, LS, Warnes, CA, Bradley, E, et al. Cardiovascular considerations in caring for pregnant patients: a scientific statement from the American Heart Association. Circulation 2020;141:e884–e903.Google Scholar
American College of Obstetricians and Gynecologists’ Presidential Task Force on Pregnancy and Heart Disease and Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 212: Pregnancy and heart disease. Obstet Gynecol 2019;133:e320–e356.Google Scholar
Roos-Hesselink, J, Baris, L, Johnson, M, et al. Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry of Pregnancy and Cardiac disease (ROPAC). Eur Heart J 2019;40:3848–3855.Google Scholar
Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 2018;39:3165–3241.Google Scholar
Silversides, CK, Grewal, J, Mason, J, et al. Pregnancy outcomes in women with heart disease: The CARPREG II Study. J Am Coll Cardiol 2018;71:2419–2430.Google Scholar
Hussey, H, Hussey, P, Meng, ML. Peripartum considerations for women with cardiac disease. Curr Opin Anaesthesiol 2021;34:218–225.Google Scholar
Meng, ML, Arendt, KW. Obstetric anesthesia and heart disease: practical clinical considerations. Anesthesiology 2021;135:164–183.Google Scholar
Girnius, A, Meng, ML. Cardio-obstetrics: a review for the cardiac anesthesia provider. J Cardiothorac Vasc Anesth 2021;35:3483–3488. https://doi.org/10.1053/j.jvca.2021.06.012Google Scholar
Wolff, GA, Weitzel, NS. Management of acquired cardiac disease in the obstetric patient. Semin Cardiothorac Vasc Anesth 2011;15:85–97.Google Scholar
Creanga, AA. Maternal mortality in the United States: a review of contemporary data and their limitations. Clin Obstet Gynecol 2018;61:296–306.Google Scholar
Levels of Maternal Care: Obstetric Care Consensus No. 9. Obstet Gynecol 2019;134:e41–e55.Google Scholar
Cardiac, May L. physiology of pregnancy. Compr Physiol 2015;5:1325–1344.Google Scholar
Tan, EK, Tan, EL. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol 2013;27:791–802.Google Scholar
Kristiansson, P, Wang, JX. Reproductive hormones and blood pressure during pregnancy. Hum Reprod 2001;16:13–17.Google Scholar
Poston, L. The control of blood flow to the placenta. Exp Physiol 1997;82:377–387.Google Scholar
Robson, SC, Hunter, S, Boys, RJ, et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989;256:H1060–1065.Google Scholar
Clark, SL, Cotton, DB, Lee, W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 1989;161:1439–1442.Google Scholar
Rees, GB, Broughton Pipkin, F, Symonds, EM, et al. A longitudinal study of respiratory changes in normal human pregnancy with cross-sectional data on subjects with pregnancy-induced hypertension. Am J Obstet Gynecol 1990;162:826–830.Google Scholar
Sayle, AE, Wilcox, AJ, Weinberg, CR, et al. A prospective study of the onset of symptoms of pregnancy. J Clin Epidemiol 2002;55:676–680.Google Scholar
Malhame, I, Hurlburt, H, Larson, L, et al. Sensitivity and specificity of B-type natriuretic peptide in diagnosing heart failure in pregnancy. Obstet Gynecol 2019;134:440–449.Google Scholar
Mhyre, JM, D’Oria, R, Hameed, AB, et al. The maternal early warning criteria: a proposal from the national partnership for maternal safety. Obstet Gynecol 2014;124:782–786.Google Scholar
American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care. Gynecologic Considerations for Adolescents and Young Women with Cardiac Conditions: ACOG Committee Opinion, No. 813. Obstet Gynecol 2020;136:e90–e99.Google Scholar
Wolfe, DS. Introduction to building the cardio-obstetric team. Clin Obstet Gynecol 2020;63:791–798.Google Scholar
American College of Obstetricians Gynecologists’ Committee on Practice Bulletins: Obstetrics. ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstet Gynecol 2018;132:e1–e17.Google Scholar
Elkayam, U, Goland, S, Pieper, PG, et al. High-risk cardiac disease in pregnancy: Part I. J Am Coll Cardiol 2016;68:396–410.Google Scholar
Sachs, A, Aaronson, J, Smiley, R. The role of the anesthesia provider in the care of the parturient with cardiac disease. Semin Perinatol 2014;38:252–259.Google Scholar
Committee on Obstetrics and Anesthesia. Guidelines for Neuraxial Anesthesia in Obstetrics: American Society of Anesthesia providers, 2018. Available from: www.asahq.org/standards-and-guidelines/guidelines-for-neuraxial-anesthesia-in-obstetrics [last accessed August 31, 2022].Google Scholar
Hale, S, Hill, CM, Hermann, M, et al. Analgesia and anesthesia in the intrapartum period. J Obstet Gynecol Neonatal Nurs 2020;49:e1–e60.Google Scholar
Cohen, KM, Minehart, RD, Leffert, LR. Anesthetic treatment of cardiac disease during pregnancy. Curr Treat Options Cardiovasc Med 2018;20:66.Google Scholar
Goldszmidt, E, Macarthur, A, Silversides, C, et al. Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery. Int J Obstet Anesth 2010;19:266–272.Google Scholar
Leth, RA, Moller, JK, Thomsen, RW, et al. Risk of selected postpartum infections after cesarean section compared with vaginal birth: a five-year cohort study of 32,468 women. Acta Obstet Gynecol Scand 2009;88:976–983.Google Scholar
Blondon, M, Casini, A, Hoppe, KK, et al. Risks of venous thromboembolism after cesarean sections: a meta-analysis. Chest 2016;150:572–596. https://doi.org/10.1016/j.chest.2016.05.021.Google Scholar
Xu, C, Fu, Q, Tao, HB, et al. Effect of cesarean section on the severity of postpartum hemorrhage in Chinese women: the Shanxi study. Curr Med Sci 2018;38:618–625.Google Scholar
Shnider, SM, Abboud, TK, Artal, R, et al. Maternal catecholamines decrease during labor after lumbar epidural anesthesia. Am J Obstet Gynecol 1983;147:13–15.Google Scholar
Delgado Garcia, DR, Latorre Andreu, P, Fernandez Tomas, B, et al. Marfan syndrome in a term-pregnant woman with aortic root dilatation between 40 and 45 mm. Rev Esp Anestesiol Reanim (Engl Ed) 2019;66:49–52.Google Scholar
Horlocker, TT, Vandermeuelen, E, Kopp, SL, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (4th ed.). Reg Anesth Pain Med 2018;43:263–309.Google Scholar
Gogarten, W, Vandermeulen, E, Van Aken, H, et al. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur J Anaesthesiol 2010;27:999–1015.Google Scholar
Leffert, L, Butwick, A, Carvalho, B, et al. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesth Analg 2018;126:928–944.Google Scholar
Chau, A, Bibbo, C, Huang, CC, et al. Dural puncture epidural technique improves labor analgesia quality with fewer side effects compared with epidural and combined spinal epidural techniques: a randomized clinical trial. Anesth Analg 2017;124:560–569.Google Scholar
Ziskind, Z, Etchin, A, Frenkel, Y, et al. Epidural anesthesia with the Trendelenburg position for cesarean section with or without a cardiac surgical procedure in patients with severe mitral stenosis: a hemodynamic study. J Cardiothorac Anesth 1990;4:354–359.Google Scholar
Liu, SS, Ware, PD, Allen, HW, et al. Dose-response characteristics of spinal bupivacaine in volunteers. Clinical implications for ambulatory anesthesia. Anesthesiology 1996;85:729–736.Google Scholar
Fan, SZ, Susetio, L, Wang, YP, et al. Low dose of intrathecal hyperbaric bupivacaine combined with epidural lidocaine for cesarean section–a balance block technique. Anesth Analg 1994;78:474–477.Google Scholar
Hamlyn, EL, Douglass, CA, Plaat, F, et al. Low-dose sequential combined spinal-epidural: an anaesthetic technique for caesarean section in patients with significant cardiac disease. Int J Obstet Anesth 2005;14:355–361.Google Scholar
Arendt, KW, Lindley, KJ. Obstetric anesthesia management of the patient with cardiac disease. Int J Obstet Anesth 2019;37:73–85.Google Scholar
Meng, ML, Bernstein, K, Hussey, P, et al. Adding to the denominator: a case report of neuraxial anesthesia for cesarean delivery in the setting of hemolysis, elevated liver enzyme, low platelet, thrombocytopenia, and pulmonary hypertension. A A Pract 2020;14:144–148.Google Scholar
Langesaeter, E, Dragsund, M, Rosseland, LA. Regional anaesthesia for a Caesarean section in women with cardiac disease: a prospective study. Acta Anaesthesiol Scand 2010;54:46–54.Google Scholar
Nolan, TE, Wakefield, ML, Devoe, LD. Invasive hemodynamic monitoring in obstetrics. A critical review of its indications, benefits, complications, and alternatives. Chest 1992;101:1429–1433.Google Scholar
Vartikar, JV, Johnson, MD, Datta, S. Precordial Doppler monitoring and pulse oximetry during cesarean delivery: detection of venous air embolism. Reg Anesth 1989;14:145–148.Google Scholar
Committee on Practice Bulletins: Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol 2017;130:e168–e186.Google Scholar
Cauldwell, M, Von Klemperer, K, Uebing, A, et al. Why is post-partum haemorrhage more common in women with congenital heart disease? Int J Cardiol 2016;218:285–290.Google Scholar
Jayasooriya, G, Silversides, C, Raghavan, G, et al. Anesthetic management of women with heart failure during pregnancy: a retrospective cohort study. Int J Obstet Anesth 2020;44:40–50.Google Scholar
Rosseland, LA, Hauge, TH, Grindheim, G, et al. Changes in blood pressure and cardiac output during cesarean delivery: the effects of oxytocin and carbetocin compared with placebo. Anesthesiology 2013;119:541–551.Google Scholar
Partridge, BL, Key, T, Reisner, LS. Life-threatening effects of intravascular absorption of PGF2 alpha during therapeutic termination of pregnancy. Anesth Analg 1988;67:1111–1113.Google Scholar
Lin, YH, Seow, KM, Hwang, JL, et al. Myocardial infarction and mortality caused by methylergonovine. Acta Obstet Gynecol Scand 2005;84:1022.Google Scholar
Langesaeter, E, Gibbs, M, Dyer, RA. The role of cardiac output monitoring in obstetric anesthesia. Curr Opin Anaesthesiol 2015;28:247–253.Google Scholar
Shimizu, K, Katoh, H, Hirano, M. Evolution into indolent myeloma in a patient with benign monoclonal gammopathy after an eleven-year-interval. Rinsho Ketsueki 1988;29:550–553.Google Scholar
Dua, S, Maurtua, MA, Cywinski, JB, et al. Anesthetic management for emergency cesarean section in a patient with severe valvular disease and preeclampsia. Int J Obstet Anesth 2006;15:250–253.Google Scholar
Pessel, C, Bonanno, C. Valve disease in pregnancy. Semin Perinatol 2014;38:273–284.Google Scholar
Siu, SC, Lam, M, Allen, B, et al. Attained pregnancy among women with a prosthetic heart valve. Eur J Obstet Gynecol Reprod Biol 2019;240:172–177.Google Scholar
Cousin, B, Guglielminotti, J, Iung, B, et al. Retrospective study of anaesthetic management of pregnancy patients with mechanical heart valve prosthesis and anticoagulants. Anaesth Crit Care Pain Med 2018;37:225–231.Google Scholar
Sillesen, M, Hjortdal, V, Vejlstrup, N, et al. Pregnancy with prosthetic heart valves – 30 years’ nationwide experience in Denmark. Eur J Cardiothorac Surg 2011;40:448–454.Google Scholar
Nishimura, RA, Otto, CM, Bonow, RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017;135:e1159–e1195.Google Scholar
Arany, Z, Elkayam, U. Peripartum cardiomyopathy. Circulation 2016;133:1397–1409.Google Scholar
Baris, L, Cornette, J, Johnson, MR, et al. Peripartum cardiomyopathy: disease or syndrome? Heart 2019;105:357–362.Google Scholar
Pearson, GD, Veille, JC, Rahimtoola, S, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA 2000;283:1183–1188.Google Scholar
Davis, MB, Arany, Z, McNamara, DM, et al. Peripartum cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol 2020;75:207–221.Google Scholar
McNamara, DM, Elkayam, U, Alharethi, R, et al. Clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy). J Am Coll Cardiol 2015;66:905–914.Google Scholar
Oindi, FM, Sequeira, E, Sequeira, HR, et al. Takotsubo cardiomyopathy in pregnancy: a case report and literature review. BMC Pregnancy Childbirth 2019;19:89.Google Scholar
Ruiz, S, Martinez-Marin, M, Luque, P, et al. Takotsubo cardiomyopathy after cesarean section: a case report and literature review. J Obstet Gynaecol Res 2017;43:392–396.Google Scholar
Ituk, US, Habib, AS, Polin, CM, et al. Anesthetic management and outcomes of parturients with dilated cardiomyopathy in an academic centre. Can J Anaesth 2015;62:278–288.Google Scholar
Lu, Y, Chen, R, Cai, J, et al. The management of hypertension in women planning for pregnancy. Br Med Bull 2018;128:75–84.Google Scholar
Roshanzamir, S, Showkathali, R. Takotsubo cardiomyopathy a short review. Curr Cardiol Rev 2013;9:191–196.Google Scholar
Midei, MG, DeMent, SH, Feldman, AM, et al. Peripartum myocarditis and cardiomyopathy. Circulation 1990;81:922–928.Google Scholar
Bozkurt, B, Villaneuva, FS, Holubkov, R, et al. Intravenous immune globulin in the therapy of peripartum cardiomyopathy. J Am Coll Cardiol 1999;34:177–180.Google Scholar
Sliwa, K, Skudicky, D, Candy, G, et al. The addition of pentoxifylline to conventional therapy improves outcome in patients with peripartum cardiomyopathy. Eur J Heart Fail 2002;4:305–309.Google Scholar
Beards, SC, Freebairn, RC, Lipman, J. Successful use of continuous veno-venous haemofiltration to treat profound fluid retention in severe peripartum cardiomyopathy. Anaesthesia 1993;48:1065–1067.Google Scholar
Cosmai, EM, Puzis, L, Tsai, HM, et al. Thrombocytopenic purpura and cardiomyopathy in pregnancy reversed by combined plasma exchange and infusion. Eur J Haematol 2002;68:239–242.Google Scholar
Samalavicius, RS, Puodziukaite, L, Radaviciute, I, et al. Prophylactic use of an intra-aortic balloon pump in a high-risk patient with peripartum cardiomyopathy requiring cesarean delivery. Int J Obstet Anesth 2018;33:67–71.Google Scholar
McIndoe, AK, Hammond, EJ, Babington, PC. Peripartum cardiomyopathy presenting as a cardiac arrest at induction of anaesthesia for emergency caesarean section. Br J Anaesth 1995;75:97–101.Google Scholar
Schaufelberger, M. Cardiomyopathy and pregnancy. Heart 2019;105:1543–1551.Google Scholar
Lampert, MB, Weinert, L, Hibbard, J, et al. Contractile reserve in patients with peripartum cardiomyopathy and recovered left ventricular function. Am J Obstet Gynecol 1997;176:189–195.Google Scholar
Elkayam, U. Risk of subsequent pregnancy in women with a history of peripartum cardiomyopathy. J Am Coll Cardiol 2014;64:1629–1636.Google Scholar
Cantwell, R, Clutton-Brock, T, Cooper, G, et al. Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011;118 Suppl. 1:1–203.Google Scholar
Callaghan, WM, Creanga, AA, Kuklina, EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol 2012;120:1029–1036.Google Scholar
Hales, CM, Carroll, MD, Fryar, CD, et al. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief 2020:1–8.Google Scholar
Martin, JA, Hamilton, BE, Osterman, MJK, et al. Births: Final Data for 2018. Natl Vital Stat Rep 2019;68:1–47.Google Scholar
Roth, A, Elkayam, U. Acute myocardial infarction associated with pregnancy. J Am Coll Cardiol 2008;52:171–180.Google Scholar
Simpson, LL. Maternal cardiac disease: update for the clinician. Obstet Gynecol 2012;119:345–359.Google Scholar
Ray, P, Murphy, GJ, Shutt, LE. Recognition and management of maternal cardiac disease in pregnancy. Br J Anaesth 2004;93:428–439.Google Scholar
Cuthill, JA, Young, S, Greer, IA, et al. Anaesthetic considerations in a parturient with critical coronary artery disease and a drug-eluting stent presenting for caesarean section. Int J Obstet Anesth 2005;14:167–171.Google Scholar
James, TN. Effective coronary perfusion pressure. Am Heart J 1961;62:427–429.Google Scholar
Ginsberg, JS, Hirsh, J. Use of antithrombotic agents during pregnancy. Chest 1995;108:305S–311S.Google Scholar
Sullebarger, JT, Fontanet, HL, Matar, FA, et al. Percutaneous coronary intervention for myocardial infarction during pregnancy: a new trend? J Invasive Cardiol 2003;15:725–728.Google Scholar
Craig, S, Ilton, M. Treatment of acute myocardial infarction in pregnancy with coronary artery balloon angioplasty and stenting. Aust N Z J Obstet Gynaecol 1999;39:194–196.Google Scholar
Eickman, FM. Acute coronary artery angioplasty during pregnancy. Cathet Cardiovasc Diagn 1996;38:369–372.Google Scholar
Sepehripour, AH, Lo, TT, Shipolini, AR, et al. Can pregnant women be safely placed on cardiopulmonary bypass? Interact Cardiovasc Thorac Surg 2012;15:1063–1070.Google Scholar
Nwiloh, JO, Oduwole, AM. Off pump coronary artery bypass surgery for multivessel disease in pregnancy. Ann Thorac Cardiovasc Surg 2016;22:57–59.Google Scholar
Schumacher, B, Belfort, MA, Card, RJ. Successful treatment of acute myocardial infarction during pregnancy with tissue plasminogen activator. Am J Obstet Gynecol 1997;176:716–719.Google Scholar
102. Gil S, Atienzar C, Filella Y, et al. Anaesthetic management of acute myocardial infarction during labour. Int J Obstet Anesth 2006;15:71–74.Google Scholar
Secher, NJ, Arnsbo, P, Wallin, L. Haemodynamic effects of oxytocin (syntocinon) and methyl ergometrine (methergin) on the systemic and pulmonary circulations of pregnant anaesthetized women. Acta Obstet Gynecol Scand 1978;57:97–103.Google Scholar
Frantz, RP, Lerman, A, Edwards, BS, et al. Methylergonovine-induced diffuse coronary spasm in a patient with exercise-induced coronary spasm after heart transplantation. J Heart Lung Transplant 1994;13:834–839.Google Scholar
Matthews, T, Dickinson, JE. Considerations for delivery in pregnancies complicated by maternal hypertrophic obstructive cardiomyopathy. Aust N Z J Obstet Gynaecol 2005;45:526–528.Google Scholar
Ashikhmina, E, Farber, MK, Mizuguchi, KA. Parturients with hypertrophic cardiomyopathy: case series and review of pregnancy outcomes and anesthetic management of labor and delivery. Int J Obstet Anesth 2015;24:344–355.Google Scholar
Shah, DM, Sunderji, SG. Hypertrophic cardiomyopathy and pregnancy: report of a maternal mortality and review of literature. Obstet Gynecol Surv 1985;40:444–448.Google Scholar
Fairley, CJ, Clarke, JT. Use of esmolol in a parturient with hypertrophic obstructive cardiomyopathy. Br J Anaesth 1995;75:801–804.Google Scholar
Okutomi, T, Kikuchi, S, Amano, K, et al. Continuous spinal analgesia for labor and delivery in a parturient with hypertrophic obstructive cardiomyopathy. Acta Anaesthesiol Scand 2002;46:329–331.Google Scholar
Minnich, ME, Quirk, JG, Clark, RB. Epidural anesthesia for vaginal delivery in a patient with idiopathic hypertrophic subaortic stenosis. Anesthesiology 1987;67:590–592.Google Scholar
Ho, KM, Ngan Kee, WD, Poon, MC. Combined spinal and epidural anesthesia in a parturient with idiopathic hypertrophic subaortic stenosis. Anesthesiology 1997;87:168–169.Google Scholar
Leyse, R, Ofstun, M, Dillard, DH, et al. Congenital aortic stenosis in pregnancy, corrected by extracorporeal circulation, offering a viable male infant at term but with anomalies eventuating in his death at four months of age–report of a case. JAMA 1961;176:1009–1012.Google Scholar
Liu, Y, Han, F, Zhuang, J, et al. Cardiac operation under cardiopulmonary bypass during pregnancy. J Cardiothorac Surg 2020;15:92.Google Scholar
Mahli, A, Izdes, S, Coskun, D. Cardiac operations during pregnancy: review of factors influencing fetal outcome. Ann Thorac Surg 2000;69:1622–1626.Google Scholar
Becker, RM. Intracardiac surgery in pregnant women. Ann Thorac Surg 1983;36:453–458.Google Scholar
Shook, LL, Barth, WH, Jr. Cardiac surgery during pregnancy. Clin Obstet Gynecol 2020;63:429–446.Google Scholar
Ong, J, Zhang, JY, Lorusso, R, et al. Extracorporeal membrane oxygenation in pregnancy and the postpartum period: a systematic review of case reports. Int J Obstet Anesth 2020;43:106–113.Google Scholar
Ramanathan, K, Tan, CS, Rycus, P, et al. Extracorporeal membrane oxygenation in pregnancy: an analysis of the extracorporeal life support organization registry. Crit Care Med 2020;48:696–703.Google Scholar
Agerstrand, C, Abrams, D, Biscotti, M, et al. Extracorporeal membrane oxygenation for cardiopulmonary failure during pregnancy and postpartum. Ann Thorac Surg 2016;102:774–779.Google Scholar
Kayem, G, Lecarpentier, E, Deruelle, P, et al. A snapshot of the Covid-19 pandemic among pregnant women in France. J Gynecol Obstet Hum Reprod 2020;49:101826.CrossRefGoogle ScholarPubMed
Saad, AF, Rahman, M, Maybauer, DM, et al. Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome: a systematic review and meta-analysis. Obstet Gynecol 2016;127:241–247.Google Scholar
Beckett, VA, Knight, M, The, Sharpe P. CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study. BJOG 2017;124:1374–1381.Google Scholar
Makdisi, G, Jan, MY, Dungy-Poythress, L, et al. Successful delivery in a patient with left ventricular assist device and unplanned pregnancy. Ann Thorac Surg 2017;104:e31–e33.Google Scholar
Malik, A, Winchester, ML, Gorman, K, et al. Left ventricular assist device in pregnancy: case report and review of the literature. J Obstet Gynaecol Res 2021;47:1589–1593.Google Scholar
LaRue, S, Shanks, A, Wang, IW, et al. Left ventricular assist device in pregnancy. Obstet Gynecol 2011;118:426–428.Google Scholar
Sims, DB, Vink, J, Uriel, N, et al. A successful pregnancy during mechanical circulatory device support. J Heart Lung Transplant 2011;30:1065–1067.Google Scholar
Lund, LH, Edwards, LB, Kucheryavaya, AY, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Official Adult Heart Transplant Report–2013; focus theme: age. J Heart Lung Transplant 2013;32:951–964.Google Scholar
Thakrar, MV, Morley, K, Lordan, JL, et al. Pregnancy after lung and heart-lung transplantation. J Heart Lung Transplant 2014;33:593–598.Google Scholar
Punnoose, LR, Coscia, LA, Armenti, DP, et al. Pregnancy outcomes in heart transplant recipients. J Heart Lung Transplant 2020;39:473–480.Google Scholar
Ma, KK, Petroff, MG, Coscia, LA, et al. Complex chimerism: pregnancy after solid organ transplantation. Chimerism 2013;4:71–77.Google Scholar
Vos, R, Ruttens, D, Verleden, SE, et al. Pregnancy after heart and lung transplantation. Best Pract Res Clin Obstet Gynaecol 2014;28:1146–1162.Google Scholar
Zheng, S, Easterling, TR, Umans, JG, et al. Pharmacokinetics of tacrolimus during pregnancy. Ther Drug Monit 2012;34:660–670.Google Scholar
Moaveni, DM, Cohn, JH, Hoctor, KG, et al. Anesthetic considerations for the parturient after solid organ transplantation. Anesth Analg 2016;123:402–410.Google Scholar
Alba, AC, Foroutan, F, Ng Fat Hing, NKV, et al. Incidence and predictors of sudden cardiac death after heart transplantation: a systematic review and meta-analysis. Clin Transplant 2018;32:e13206.Google Scholar
Boule, S, Ovart, L, Marquie, C, et al. Pregnancy in women with an implantable cardioverter-defibrillator: is it safe? EP Europace Europace 2014;16:1587–1594.CrossRefGoogle ScholarPubMed
Han, Y, Zhang, Z, Sun, Q, et al. Combined spinal-epidural anesthesia for cesarean delivery in a patient with cor triloculare biventriculare. BMC Anesthesiol 2017;17:115.Google Scholar
Cordone, M, Wolfson, A, Wolfson, N, et al. Anesthetic management of labor in a patient with congenitally corrected transposition of the great arteries. Int J Obstet Anesth 2008;17:57–60.Google Scholar
Arendt, KW, Connolly, HM, Warnes, CA, et al. Anesthetic management of parturients with congenitally corrected transposition of the great arteries: three cases and a review of the literature. Anesth Analg 2008;107:1973–1977.Google Scholar
Bhatt, AB, DeFaria Yeh, D. Pregnancy and adult congenital heart disease. Cardiol Clin 2015;33:611–623, ix.Google Scholar
Rao, S, Ginns, JN. Adult congenital heart disease and pregnancy. Semin Perinatol 2014;38:260–272.Google Scholar
Kumar, V, Khatwani, M, Aneja, S, et al. Paradoxical amniotic fluid embolism presenting before caesarean section in a woman with an atrial septal defect. Int J Obstet Anesth 2010;19:94–98.Google Scholar
Gang, SP, Fang, KY, Ma, Y, et al. Anesthetic management for cesarean delivery in a patient with uncorrected pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arteries. Int J Obstet Anesth 2018;36:125–129.Google Scholar
Thakur, D, Modak, S, Rayadurg, V, et al. Combined general and epidural anesthesia for emergency cesarean delivery of twins in a parturient with coarctation of aorta. AANA J 2019;87:437–440.Google Scholar
Tawfik, MM, Tarbay, AI, Abdelkhalek, M. Cesarean section in parturients with uncorrected tetralogy of Fallot. Int J Obstet Anesth 2015;24:191–192.Google Scholar
Arendt, KW, Fernandes, SM, Khairy, P, et al. A case series of the anesthetic management of parturients with surgically repaired tetralogy of Fallot. Anesth Analg 2011;113:307–317.Google Scholar
Kanoh, M, Inai, K, Shinohara, T, et al. Influence of pregnancy on cardiac function and hemodynamics in women with Ebstein’s anomaly. Acta Obstet Gynecol Scand 2018;97:1025–1031.Google Scholar
Tiouririne M, de Souza DG, Beers KT, et al. Anesthetic management of parturients with a Fontan circulation: a review of published case reports. Semin Cardiothorac Vasc Anesth 2015;19:203–209.Google Scholar
Jooste, EH, Haft, WA, Ames, WA, et al. Anesthetic care of parturients with single ventricle physiology. J Clin Anesth 2013;25:417–423.Google Scholar
Dob, DP, Naguib, MA, Gatzoulis, MA. A functional understanding of moderate to complex congenital heart disease and the impact of pregnancy. Part I: the transposition complexes. Int J Obstet Anesth 2010;19:298–305.Google Scholar
Maxwell, BG, El-Sayed, YY, Riley, ET, et al. Peripartum outcomes and anaesthetic management of parturients with moderate to complex congenital heart disease or pulmonary hypertension*. Anaesthesia 2013;68:52–59.Google Scholar
Yang, CY, Wei, W, Tao, GC. Dangers of rapid oxytocin administration in Eisenmenger’s Syndrome. Int J Obstet Anesth 2011;20:96–97.Google Scholar
Mishra, L, Pani, N, Samantaray, R, et al. Eisenmenger’s syndrome in pregnancy: use of epidural anesthesia and analgesia for elective cesarean section. J Anaesthesiol Clin Pharmacol 2014;30:425–426.Google Scholar
Lipman, S, Cohen, S, Einav, S, et al. The Society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy. Anesth Analg 2014;118:1003–1016.Google Scholar
Mhyre, JM, Tsen, LC, Einav, S, et al. Cardiac arrest during hospitalization for delivery in the United States, 1998–2011. Anesthesiology 2014;120:810–818.Google Scholar
Jeejeebhoy, FM, Zelop, CM, Lipman, S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation 2015;132:1747–1773.Google Scholar
Zelop, CM, Einav, S, Mhyre, JM, et al. Characteristics and outcomes of maternal cardiac arrest: a descriptive analysis of Get with the guidelines data. Resuscitation 2018;132:17–20.Google Scholar
Fischer, C, Bonnet, MP, Girault, A, et al. Update: focus in-hospital maternal cardiac arrest. J Gynecol Obstet Hum Reprod 2019;48:309–314.Google Scholar
van Liempt, SW, Stoecklein, K, Tjiong, MY, et al. Essentials in cardiac arrest during cesarean section. Clin Pract 2015;5:668.Google Scholar
Merchant, RM, Topjian, AA, Panchal, AR, et al. Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020;142:S337–S357.Google Scholar
Eldridge, AJ, Ford, R. Perimortem caesarean deliveries. Int J Obstet Anesth 2016;27:46–54.Google Scholar
Madden, AM, Meng, ML. Cardiopulmonary resuscitation in the pregnant patient. BJA Educ 2020;20:252–258.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×