Maternal morbidity and mortality as a result of cardiac disease is increasing in the United States. Safe management of pregnancy in women with heart disease requires appropriate anesthetic, cardiac, and obstetric care. The anesthesiologist should risk stratify pregnant patients based upon cardiac disease etiology and severity in order to determine the appropriate type of hospital and location within the hospital for delivery and anesthetic management. Increased intrapartum hemodynamic monitoring may be necessary and neuraxial analgesia and anesthesia is typically appropriate. The anesthesiologist should anticipate obstetric and cardiac emergencies such as emergency cesarean delivery, postpartum hemorrhage, and peripartum arrhythmias. This clinical review answers practical questions for the obstetric anesthesiologist and the nonsubspecialist anesthesiologist who regularly practices obstetric anesthesiology.
Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations
This article is featured in “This Month in Anesthesiology,” page A1.
Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
Submitted for publication August 11, 2020. Accepted for publication April 26, 2021.
- Views Icon Views
- Share Icon Share
- Search Site
Marie-Louise Meng, Katherine W. Arendt; Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations. Anesthesiology 2021; 135:164–183 doi: https://doi.org/10.1097/ALN.0000000000003833
Download citation file: