Anesthetic and analgesic management of mitral stenosis during pregnancy

Pan, Peter H.; D’Angelo, Robert

doi:10.1016/j.rapm.2004.09.006

Cited by 12 publications

(7 citation statements)

References 46 publications

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“…Functional classification has been found to have a high correlation with prognosis in pregnant patients with PH and with mitral valve disease,[ 5 6 7 8 ] and it is the patients’ exercise tolerance that primarily directs clinical management. Many patients with severe disease cope well in their day to day lives and report little in the way of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Mortality is 1% for NYHA classes II and I and increases to 5% for NYHA classes III and IV. [ 5 6 7 ] In the presence of atrial fibrillation, the mortality increases to 14–15%. [ 6 7 ] There is a higher fetal and neonatal complication rate in women with a history of cardiac events or symptoms prior to pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 6 7 ] In the presence of atrial fibrillation, the mortality increases to 14–15%. [ 6 7 ] There is a higher fetal and neonatal complication rate in women with a history of cardiac events or symptoms prior to pregnancy. [ 6 7 ] The risk is greatest near term and in the peripartum period.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 7 ] There is a higher fetal and neonatal complication rate in women with a history of cardiac events or symptoms prior to pregnancy. [ 6 7 ] The risk is greatest near term and in the peripartum period. [ 5 6 ] Intensive medical management of patients with developing heart failure is successful in stabilizing most symptomatic patients[ 7 12 ] and allows many to continue the pregnancy to term and improves maternal condition for delivery.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

et al. 2015

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Background:Pulmonary hypertension (PH) in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%.Aim:To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses.Materials and Methods:A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly.Results:19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice.Conclusion:Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

et al. 2015

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“…Epidural anaesthesia with titrated doses of local anaesthetic is the preferred technique. Drug of choice for hypotension is low dose phenylepherine (50 to 100 μg) Oxytocin should be used with caution 2,11,39 .…”

Section: Csmentioning

confidence: 99%

Pregnancy in cardiac disease: clinical, obstetric and anaesthetic concerns

Jindal

Bajwa

et al. 2012

Sri Lanka J Obstet & Gynae

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In the past patients with cardiac disease were advised against pregnancy. With improved cardiac care and better obstetric as well as anaesthetic facilities, pregnant cardiac patients are on rise. Their management involves joint efforts of cardiologist, obstetrician and anaesthetist. Instead of a specific technique, what underlies a successful anaesthesia in cardiac patients is maintenance of haemodynamic stability and avoiding adverse physiological effects of parturition on maternal pathophysiology. Both regional as well as general anaesthesia provide successful outcomes. Vaginal delivery is preferred over caesarean section.

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A Pregnant Patient with Mitral Stenosis

Herway

Archer

2013

Clinical Anesthesiology

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Anesthetic and analgesic management of mitral stenosis during pregnancy

Cited by 12 publications

References 46 publications

Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

Pregnancy in cardiac disease: clinical, obstetric and anaesthetic concerns

A Pregnant Patient with Mitral Stenosis

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