Skip to main content

Anesthesia for Cardiac Surgery during Pregnancy

  • Chapter
Principles of Medical Therapy in Pregnancy

Abstract

Over the past 25 years the incidence of heart disease during pregnancy has declined from 3.6% to approximatel, 1.6% (Fig. 113–1).1–8 Rheumatic heart disease accounts for most cases. The number of pregnant patients with congenital heart disease has been increasing because women with congenital heart defects now reach childbearing age as a result of improvements in medical and surgical therapy. 2,5,9

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ueland K: Cardiovascular diseases complicating pregnancy. Clin Obstet Gynecol 21: 429–442, 1978

    Article  PubMed  CAS  Google Scholar 

  2. Szekely P, Snaith L: Heart Disease and Pregnancy. London, Churchill Livingston, 1974, p 149

    Google Scholar 

  3. Barnes CG: Medical Disorders in Obstetrics Practice, ed 3. Oxford, Blackwell, 1970, p 11

    Google Scholar 

  4. Mendelson CL: Heart disease and pregnancy. Clin Obstet Gynecol 4: 603–629, 1 961

    Google Scholar 

  5. Mendelson CL, Metcalfe J: Cardiac Disease and Pregnancy. Philadelphia, FA Davis, 1960

    Google Scholar 

  6. Burwell CS, Metcalfe J: Heart Disease and Pregnancy. Boston, Little, Brown, 1958, pp 210, 217, 220

    Google Scholar 

  7. Niswander K, Berendes H, Deutschbeger J, et al: Fetal mortality following potential anoxigenic conditions. Am J Obstet Gyneco198: 871–876, 1967

    PubMed  CAS  Google Scholar 

  8. Szekely P, Snaith L: Atrial fibrillation and pregnancy. Br Med J 1: 1407–1410, 1961

    Article  PubMed  CAS  Google Scholar 

  9. Cannell DE, Vernon CP: Congenital heart disease and pregnancy. Am J Obstet Gyneco1 85: 744–753, 1963

    CAS  Google Scholar 

  10. Palahniuk RJ, Shnider SM, Eger El II: Pregnancy decreases the requirement for inhaled anesthetic agents. Anesthesiology 41: 82–83, 1974

    Article  PubMed  CAS  Google Scholar 

  11. Zitnik KS, Brandenburg R0, Sheldon R, et al: Pregnancy and open heart surgery. Circulation 39 (Suppl) 1: 257–262, 1969

    Google Scholar 

  12. Koh KS, Friesen RM, Livingstone RA, et al: Fetal monitoring during maternal cardiac surgery with cardiopulmonary by-pass. Can Med Assoc J 112: 110–1104, 1975

    Google Scholar 

  13. Werch A, Lambert HM: Fetal monitoring and maternal open heart surgery. South Med J 70: 1024, 1977

    Article  PubMed  CAS  Google Scholar 

  14. Trimakas AP, Maxwell KD, Berkay S, et al: Fetal monitoring during cardiopulmonary bypass for removal of a left atrial myxoma during pregnancy. Johns Hopkins Med J 144: 156–160, 1979

    PubMed  CAS  Google Scholar 

  15. Eilen B, Kaiser IH, Becker RM, et al: Aortic valve replacement in the third trimester of pregnancy: Case report and review of the literature. Obstet Gynecol 57: 119–121, 1981

    PubMed  CAS  Google Scholar 

  16. Lamb MP, Ross K, Johnstone AM, et al: Fetal heart monitoring during open heart surgery. Two case reports. Br J Obstet Gynaecol 88: 669–674, 1981

    Article  PubMed  CAS  Google Scholar 

  17. Katz JD, Hook R, Barash PG: Fetal heart rate monitoring in pregnant patients undergoing surgery. Am J Obstet Gynecol 125: 267–269, 1976

    PubMed  CAS  Google Scholar 

  18. Levy DL, Warriner RA, Burgess GE: Fetal response to cardiopulmonary bypass. Obstet Gynecol 56: 112–115, 1980

    PubMed  CAS  Google Scholar 

  19. Page PA, Toung T: A new probe for measurement of muscle P02 and its use during cardiopulmonary bypass surgery. Gynecol Obstet 141: 579–581, 1975

    CAS  Google Scholar 

  20. Meffert WG, Stansel HC: Open heart surgery during pregnancy. Am J Obstet Gynecol 102: 1116–1120, 1968

    PubMed  CAS  Google Scholar 

  21. Levinson G, Shnider SM: Vasopressors in obstetrics. Clin Anesth 10: 77–109, 1974

    PubMed  CAS  Google Scholar 

  22. Greiss FC, Pick JR: The uterine vascular bed: Adrenergic receptors. Obstet Gynecol 23: 209–213, 1964

    PubMed  Google Scholar 

  23. Greiss FC, Crandell DL: Therapy for hypotension induced by spinal anesthesia during pregnancy. JAMA 191: 793–796, 1965

    PubMed  CAS  Google Scholar 

  24. Cibils LA, Pose SV, Zuspan FP: Effect of l-norepinephrine infusion on uterine contractility and the cardiovascular sys-tem. Am J Obstet Gyneco184: 307–317, 1962

    Google Scholar 

  25. James FM III, Greiss FC, Kemp RA: An evaluation of vas-opressor therapy for maternal hypotension during spinal anesthesia. Anesthesiology 33: 25–34, 1970

    Article  PubMed  Google Scholar 

  26. Shnider SM, deLorimier AA, Holl JW, et al: Vasopressors in obstetrics. I. Correction of fetal acidosis with ephedrine during spinal hypotension. Am J Obstet Gynecol 102: 911–919, 1968

    PubMed  CAS  Google Scholar 

  27. Kaiser IH, Harris JS: The effect of adrenalin on the pregnant human uterus. Am J Obstet Gyneco1 59: 775-–84,1950

    Google Scholar 

  28. Rolbin SH, Levinson G, Shnider SM, et al: Dopamine treatment of spinal hypotension decreases uterine blood flow in the pregnant ewe. Anesthesiology 51: 37–40, 1979

    Article  PubMed  CAS  Google Scholar 

  29. Blanchard K, Dandavino A, Nuwayhid B, et al: Systemic and uterine hemodynamic responses to dopamine in pregnant and non-pregnant sheep. Am J Obstet Gynecol 130: 669–673, 1978

    PubMed  CAS  Google Scholar 

  30. Callender K, Levinson G, Shnider SM, et al: Dopamine ad-ministration in the normotensive pregnant ewe. Obstet Gynecol 51: 586–589, 1978

    Article  PubMed  CAS  Google Scholar 

  31. Kresnow N, Rolett EL, Yurchak PM, et al: Isoproterenol and cardiovascular performance. Am J Med 37: 514–525, 1964

    Article  Google Scholar 

  32. Mahon WA, Reid DWJ, Day RA: The in vivo effects of beta adrenergic stimulation and blockade on the human uterus at term. J Pharmacol Exp Ther 156: 178–185, 1967

    PubMed  CAS  Google Scholar 

  33. Schlant RC, Tsagaris TS, Robertson RJ Jr: Studies on the acute cardiovascular effects of intravenous sodium nitroprusside. Am J Cardiol 9: 51–59, 1962

    Article  PubMed  CAS  Google Scholar 

  34. Styles MB, Coleman AJ, Leary WP: Some hemodynamic effects of sodium nitroprusside. Anesthesiology 38: 173–176, 1973

    Article  PubMed  CAS  Google Scholar 

  35. Ross G, Cole PV: Cardiovascular actions of sodium nitro-prusside in dogs. Anesthesia 28: 400–406, 1973

    Article  CAS  Google Scholar 

  36. Ring G, Krames E, Shnider SM, et al: Comparison of nitro-prusside and hydralazine in hypertensive pregnant ewes. Obstet Gynecol 50: 598–602, 1977

    PubMed  CAS  Google Scholar 

  37. Naulty JS, Cefalo R, Rodkey FL: Placental transfer and fetal toxicity of sodium nitroprusside, in: Abstracts of Scientific Papers, Annual Meeting. San Francisco, American Society of Anesthesiologists, 1976, p 543

    Google Scholar 

  38. Brinkman CR III, Assali NS: Uteroplacental hemodynamic response to antihypertensive drugs in hypertensive pregnant sheep, in Linderheimer MD, Katz AL, Zuspan FP (eds): Hypertension in Pregnancy. New York, John Wiley & Sons, 1976, pp 363–375

    Google Scholar 

  39. Nazarian M, McCullough G, Fielder D, et al: Bacterial endocarditis in pregnancy. J Thorac Cardiovasc Surg 71: 880–883, 1976

    PubMed  CAS  Google Scholar 

  40. Rowbotham GF, Bell K, Akenhead J, et al: A serious head injury in a pregnant women treated by hypothermia. Lancet 1: 1016–1019, 1957

    Google Scholar 

  41. Shnider SM, Webster GM: Maternal and fetal hazards of surgery during pregnancy. Am J Obstet Gynecol 92: 891–900, 1965

    PubMed  CAS  Google Scholar 

  42. Smith BE: Fetal prognosis after anesthesia during gestation. Anesth Analg 42: 521–526, 1963

    Article  PubMed  CAS  Google Scholar 

  43. Lloyd TS: The safety of surgical operations during pregnan-cy. South Med J 58: 179–184, 1965

    Article  PubMed  Google Scholar 

  44. Ueland K: Cardiac surgery in pregnancy. Am J Obstet Gynecol 92: 148–162, 1965

    PubMed  CAS  Google Scholar 

  45. Jacobs WM, Cooley D, Goen GP: Cardiac surgery with extracorporeal circulation during pregnancy. Report of three cases. Obstet Gynecol 24: 167–169, 1965

    Google Scholar 

  46. Khazin AF, Hon EH, Hehre FW: Effects of maternal hyperoxia on the fetus. I. Oxygen tension. Am J Obstet Gynecol 109: 628–637, 1971

    PubMed  CAS  Google Scholar 

  47. Walker A, Madderin L, Day E, et al: Fetal scalp tissue oxygen measurements in relation to maternal dermal oxygen tension and fetal heart rate. J Obstet Gynaecol Br Commonw 78: 1–12, 1971

    Article  PubMed  CAS  Google Scholar 

  48. Marx GF, Mateo CV: Effects of different oxygen concentration during general anesthesia for elective cesarean section. Can Anaesth Soc J 18: 587–593, 1971

    Article  PubMed  CAS  Google Scholar 

  49. Motoyama EK, Rivard G, Acheson F, et al: The effects of changes in maternal pH and PC02 on the Pot of fetal lambs. Anesthesiology 28: 891–903, 1967

    Article  PubMed  CAS  Google Scholar 

  50. Levine W, Diamond B: Surgical procedures during pregnancy. Am J Obstet Gynecol 81: 1046–1052, 1961

    PubMed  CAS  Google Scholar 

  51. Bronstein ES, Friedman M: Acute appendicitis in pregnancy. Am J Obstet Gynecol 86: 514–516, 1963

    PubMed  CAS  Google Scholar 

  52. Bassett JW: Appendicitis in pregnancy. Am J Obstet Gynecol 82: 828–832, 1961

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1985 Plenum Publishing Corporation

About this chapter

Cite this chapter

Abboud, T.K., Viljoen, J.F. (1985). Anesthesia for Cardiac Surgery during Pregnancy. In: Gleicher, N. (eds) Principles of Medical Therapy in Pregnancy. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2415-7_113

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-2415-7_113

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9471-9

  • Online ISBN: 978-1-4613-2415-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics