Open AccessObstetric Anesthesia and Heart Disease: Practical Clinical Considerations
Author(s) -
Marie-Louise Meng,
Katherine W. Arendt
Publication year - 2021
Publication title -
anesthesiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.874
H-Index - 234
eISSN - 1528-1175
pISSN - 0003-3022
DOI - 10.1097/aln.0000000000003833
Subject(s) - medicine , anesthesiology , obstetric anesthesia , pregnancy , cesarean delivery , heart disease , disease , intensive care medicine , etiology , neuraxial blockade , anesthesia , medical emergency , cardiology , spinal anesthesia , biology , genetics
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.