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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on March 2, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(2):44-47; doi:10.1093/bjaceaccp/mkp005
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Management of cardiac disease in pregnancy

Christiana C. Burt, MA MB BChir FRCA
Specialist Registrar in Anaesthesia
West Suffolk Hospital
Bury St Edmunds
UK

Jacqueline Durbridge, FRCA
Consultant in Anaesthesia
Chelsea and Westminster Hospital
London
UK
Tel: +44 208 746 8026 Fax: +44 208 746 8801 E-mail: jacqueline.durbridge@chelwest.nhs.uk

The first 150 words of the full text of this article appear below.


Key points

Cardiac disease is the most common cause of mortality in pregnancy.
Cardiac disease has the potential to remain undiagnosed; it may present with cardiovascular decompensation during pregnancy, at the time of delivery, or immediately post-partum.
The main aims of management are: early risk assessment, optimization, regular monitoring for deterioration, planning of delivery, and surveillance for deterioration in the immediate post-partum period.
Vaginal delivery with low-dose regional analgesia and careful fluid management is the preferred delivery mode in most cases.
Dyspnoea and tachycardia are not always due to pulmonary embolism. If the investigations for this are negative, echocardiography should be performed and a cardiology opinion sought.

 

Pregnancy makes a significant demand on the cardiovascular system. Therefore, it follows that women with cardiovascular compromise due to cardiac disease need specialist input and careful management pre-, peri-, and post-partum. In the latest CEMACH report, cardiac disease was the most common cause . . . [Full Text of this Article]


   Physiological changes in the cardiovascular system during pregnancy
 

   General principles of management
 
Pre-delivery

Mode of delivery

Post-partum


   Specific high-risk conditions
 
Myocardial infarction

Aortic dissection

Valvular heart disease

Pulmonary hypertension

Peripartum cardiomyopathy


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