Issue |
J Extra Corpor Technol
Volume 25, Number 2, June 1993
|
|
---|---|---|
Page(s) | 61 - 66 | |
DOI | https://doi.org/10.1051/ject/1993252061 | |
Published online | 21 August 2023 |
Review
Cardiopulmonary Bypass and the Pregnant Patient: A Review
St. Vincent’s Medical Center, Jacksonville, Florida
* Address correspondence to: John Josephs, MS, CCP Staff Perfusionist Department of Cardiovascular Surgery St. Vincent’s Medical Center 1800 Barrs Street Jacksonville, Florida 32204
Increasing maternal age within the general population in conjunction with cardiac disease during pregnancy, increases the probability that perfusionists will be called upon to provide extracorporeal support to the gravid patient.
Reviewing the available literature regarding cardiopulmonary bypass (CPB) during pregnancy produces some satisfying, isolated single-case reports. However, in the majority of reports, fetal compromise resulted from maternal cardio-surgical intervention.
Given the occurrence of CPB during pregnancy with resultant fetal loss, a need has been identified to provide perfusionists with a guide to patient management. Toward this effort, insights into normal physiologic and hemodynamic changes of pregnancy and their relationship to technical management of perfusion is presented. Concise information is provided regarding fetal responses to CPB and fetal distress. Situations most associated with intrauterine fetal loss and premature labor are identified. Constant monitoring of fetal heart rate is emphasized and optimal pharmacological management to achieve desired maternal effect while minimizing fetal response is also presented.
Key words: cardiopulmonary bypass / pregnancy / uterine blood flow / autoregulation / placental transfer / teratogenicity
© 1993 AMSECT
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