Management of Complex Cardiac Issues in the Pregnant Patient

Research output: Contribution to journalArticlepeer-review

Abstract

Management of peripartum heart disease in the intensive care unit requires optimization of maternal hemodynamics and maintenance of fetal perfusion. This requires fetal monitoring and should address the parturient's oxygen saturation, hemoglobin, and cardiac output as it relates to uterine blood flow. Pharmacologic strategies have limited evidence pertaining to hemodynamic stabilization and fetal perfusion. There is some evidence that surgical management of critical mitral stenosis should be percutaneous when possible because cardiac bypass is associated with increased fetal mortality. Fetal monitoring strategies should address central organ perfusion because peripheral scalp pH has not been associated with improved fetal outcomes.

Original languageEnglish
Pages (from-to)97-107
Number of pages11
JournalCritical Care Clinics
Volume32
Issue number1
DOIs
StatePublished - Jan 2016

ASJC Scopus Subject Areas

  • Critical Care and Intensive Care Medicine

Keywords

  • Fetal monitoring
  • Fetal oxygenation
  • ICU management of cardiac disease during pregnancy
  • Valvular heart disease during pregnancy
  • Vasopressor effects on fetal oxygenation
  • Pregnancy Complications, Cardiovascular/mortality
  • Cardiopulmonary Bypass/adverse effects
  • Fetal Monitoring/methods
  • Humans
  • Anticoagulants/adverse effects
  • Fetus/physiology
  • Fetal Mortality
  • Pregnancy
  • Pregnancy Outcome/epidemiology
  • Oxygen Consumption/physiology
  • Animals
  • Maternal-Fetal Exchange/drug effects
  • Female
  • Sheep
  • Placental Circulation/physiology
  • Disease Models, Animal

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