Patel A, Asopa S, Tang A, Ohri S. Cardia surgery during pregnancy. Texas Heart Institute Journal/From The Texas Heart Institute Of St Luke’s Episcopal, Texas Children’s Hospital [serial online]. 2008;35(3):307-312. Available from: MEDLINE Complete, Ipswich, MA. Accessed January,2016
Standard cardiopulmonary bypass alone is a very delicate procedure which requires a focus on the part of the Operation's Team. Considering the dynamics of the procedure and unforeseen complications that may surface, performing cardiac surgery on a pregnant woman with abnormal heart condition increases the likelihood of having an unfortunate incident.
This article provides an overview of possible causes that make the cardiopulmonary bypass procedure very challenging …show more content…
They account for most of the cardiac diseases shown in women of childbearing age. There are also non-congenital heart diseases such as, mitral stenosis, aortic valve insufficiency, which are acquired conditions. However, the understanding is that most cardiac valvular diseases manifest during pregnancy are usually due to rheumatic fever.
How to predict the maternal and fetal outcome? The average success of a cardiac operation can be evaluated based on whether the patient survives the procedure and recovers all cognitive functions. However, both maternal and fetal outcome should be considered when dealing with pregnancy cases. The rate of maternal mortality has improved to a level that is comparable that in non-pregnant women. Unfortunately, the same cannot be said for the fetuses.
The author referenced a study conducted in the United Kingdom. He reported that maternal death during pregnancy has been the result of cardiac disease in the mother and congenital cardiac disease account for 25% of those deaths. There are other predictors such as, left heart occlusion, left ventricle systolic dysfunction, experienced by the mother. For complication with the fetus, 20% of deaths were due to oxygenation, obstruction of the left heat, and …show more content…
There is an increase in oxygen, nutrients, due to the presence of the baby in the womb. Adequate blood flow is necessary for the survival of the mother and the fetus. Throughout the trimesters, the cardiac output gradually increases to ensure proper oxygenation and nutrition. However, the blood volume is not always at the optimum due to the compression of the gravid uterus on the vena cava. Consequently, this results in a reduction of the cardiac output. The author suggested laying the patient in the left lateral decubitus position to release the compression. It is also important to look at the maternal response to cardiopulmonary bypass. Despite the physiological changes taking place in the mother’s body, the effect of hemodilution, complement activation, and hypotension, according to the author, the mother seems to have a certain level of tolerance to these changes.
The author also spoke about the uterine response of the mother to cardiopulmonary bypass in a sense that continuous contraction is associated with both cooling and rewarming phase during the procedure. He further explained that sustained contraction of the uterine can exert blood flow through the intervillous space while the normal systemic blood flow is reduced. This abnormal perfusion will result in fetoplacental insufficiency and ultimately lead to the death of the fetus due to hypoxia. This fetal death is the most common in cardiopulmonary
Standard cardiopulmonary bypass alone is a very delicate procedure which requires a focus on the part of the Operation's Team. Considering the dynamics of the procedure and unforeseen complications that may surface, performing cardiac surgery on a pregnant woman with abnormal heart condition increases the likelihood of having an unfortunate incident.
This article provides an overview of possible causes that make the cardiopulmonary bypass procedure very challenging …show more content…
They account for most of the cardiac diseases shown in women of childbearing age. There are also non-congenital heart diseases such as, mitral stenosis, aortic valve insufficiency, which are acquired conditions. However, the understanding is that most cardiac valvular diseases manifest during pregnancy are usually due to rheumatic fever.
How to predict the maternal and fetal outcome? The average success of a cardiac operation can be evaluated based on whether the patient survives the procedure and recovers all cognitive functions. However, both maternal and fetal outcome should be considered when dealing with pregnancy cases. The rate of maternal mortality has improved to a level that is comparable that in non-pregnant women. Unfortunately, the same cannot be said for the fetuses.
The author referenced a study conducted in the United Kingdom. He reported that maternal death during pregnancy has been the result of cardiac disease in the mother and congenital cardiac disease account for 25% of those deaths. There are other predictors such as, left heart occlusion, left ventricle systolic dysfunction, experienced by the mother. For complication with the fetus, 20% of deaths were due to oxygenation, obstruction of the left heat, and …show more content…
There is an increase in oxygen, nutrients, due to the presence of the baby in the womb. Adequate blood flow is necessary for the survival of the mother and the fetus. Throughout the trimesters, the cardiac output gradually increases to ensure proper oxygenation and nutrition. However, the blood volume is not always at the optimum due to the compression of the gravid uterus on the vena cava. Consequently, this results in a reduction of the cardiac output. The author suggested laying the patient in the left lateral decubitus position to release the compression. It is also important to look at the maternal response to cardiopulmonary bypass. Despite the physiological changes taking place in the mother’s body, the effect of hemodilution, complement activation, and hypotension, according to the author, the mother seems to have a certain level of tolerance to these changes.
The author also spoke about the uterine response of the mother to cardiopulmonary bypass in a sense that continuous contraction is associated with both cooling and rewarming phase during the procedure. He further explained that sustained contraction of the uterine can exert blood flow through the intervillous space while the normal systemic blood flow is reduced. This abnormal perfusion will result in fetoplacental insufficiency and ultimately lead to the death of the fetus due to hypoxia. This fetal death is the most common in cardiopulmonary