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Critical care clinics · Jan 2016
ReviewManagement of Complex Cardiac Issues in the Pregnant Patient.
- Huayong Hu and Ioana Pasca.
- Department of Anesthesiology, Yale New Haven Hospital, New Haven, CT, USA. Electronic address: Huayong.hu@gmail.com.
- Crit Care Clin. 2016 Jan 1; 32 (1): 97-107.
AbstractManagement 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.Copyright © 2016 Elsevier Inc. All rights reserved.
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