Fetal Doppler monitoring during maternal open-heart surgery: Case report and key aspects of a multidisciplinary challenge

Brandstetter, Maximilian; Neuner, Matthias; Dinges, Christian; Hofstätter, Edda; Wohlmuth, Christoph; Fazelnia, C; Fischer, Thorsten; Bogner, Gerhard

doi:10.1016/j.ejogrb.2023.05.034

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The type of monitoring (intermittent or continuous) should be determined on a case-by-case decision, based on type of surgery and gestational age. 3 Brandstetter et al 4 suggest serial fetal Doppler ultrasound examinations of the fetal and fetomaternal blood flow also before viability to detect fetal stress caused by hypotension, maternal acidosis, and/or hypercapnia early and to take corrective action. Because of limited data on fetal surveillance during open heart surgery on CPB and its benefits, especially before fetal viability, no standards or guidelines are currently in place.…”

Section: Discussionmentioning

confidence: 99%

“… 5 During general anesthesia for open cardiac surgery on CPB, there is a risk for maternal hypoxia and hypotension, which is highest during transition from corporal to extracorporeal circulation. 4 Little is known about the effect of these changes on the fetal cerebral perfusion and its sequelae. In term or near-term infants, there is evidence that acute perinatal hypoxia can cause fetal encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Infective Endocarditis Requiring Mitral Valve Replacement During Second Trimester of Pregnancy

Jost,

Remmersmann,

Silaschi

et al. 2024

JACC: Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis Requiring Mitral Valve Replacement During Second Trimester of Pregnancy

Jost,

Remmersmann,

Silaschi

et al. 2024

JACC: Case Reports

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Carbon dioxide

2023

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Cardiopulmonary bypass of acute type A aortic dissection during pregnancy at the 20th gestational week with maternal and foetal survival: A case report

Wang,

Yi,

Qin

et al. 2024

Perfusion

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Background Type A acute aortic dissection, an aggressive and highly fatal disease, is particularly common among pregnant women and foetuses. This disease often occurs during the third trimester of pregnancy and the postpartum period. Case Report This case involves a female who was 20 weeks pregnant with type A acute aortic dissection. While maintaining pregnancy, the patient underwent Bentall surgery and Sun’s procedure. The duration of circulatory arrest was a brief 4 min. The patient fully recovered 40 days after surgery and remained pregnant post-discharge. At the 38th gestational week, she delivered a healthy male infant via caesarean section. Clinical Discussion Gestational morbidity can have a serious impact on the safety of mothers and children. Currently, the shortest time reported for hypothermic circulatory arrest is 5 min. In this case, the lower body circulatory arrest was controlled to approximately 4 min during cardiopulmonary bypass while simultaneously safeguarding both individuals. Ideal strategies for cardiopulmonary bypass to reduce foetal risk include shorter cardiopulmonary bypass times, higher flow rates, and higher perfusion pressures. A reduction in the duration of hypothermic circulatory arrest further increases foetal survival rates. Conclusions The development of a rational cardiopulmonary bypass plan should be tailored to the physiological characteristics of the pregnant woman to ensure the safety of both the pregnant woman and the foetus, reduce complications, and improve the success rate of the operation.

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Fetal Doppler monitoring during maternal open-heart surgery: Case report and key aspects of a multidisciplinary challenge

Cited by 3 publications

References 17 publications

Infective Endocarditis Requiring Mitral Valve Replacement During Second Trimester of Pregnancy

Infective Endocarditis Requiring Mitral Valve Replacement During Second Trimester of Pregnancy

Carbon dioxide

Cardiopulmonary bypass of acute type A aortic dissection during pregnancy at the 20th gestational week with maternal and foetal survival: A case report

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