UK registry of high-risk obstetric anaesthesia: arrhythmias, cardiomyopathy, aortic stenosis, transposition of the great arteries and Marfan’s syndrome

Peripartum anesthetic management of patients with aortic valve stenosis: a retrospective study and literature review

“…24 In one series, 65% of pregnant patients with AS had shortness of breath, palpitations, angina or dizziness in the peripartum period. 19 The rate of significant cardiac complications is almost 10% and includes pulmonary edema and arrhythmias. 3…”

“…Like the patients reported in the UK registry, many of our patients had relatively mild symptoms and were not in heart failure at the time of delivery, reducing the likelihood of neonatal depression. 19 Monitoring Standard monitoring, including frequent non-invasive blood pressure, electrocardiogram and pulse oximetry is usually adequate for vaginal delivery, but invasive monitoring may facilitate management of some patients. An arterial line allows close monitoring of systemic blood pressure.…”

Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery

“…15 Previous literature on anesthetic management of these patients has relied mostly on case reports in women with specific lesions. [16][17][18][19][20][21][22][23][24][25] There have been no large prospective studies examining anesthetic approaches and associated outcomes in women with heart disease. Our institutions, Toronto General Hospital, a part of University Health Network, and Mount Sinai Hospital, are in a unique position to examine anesthetic outcomes in a large consecutive group of women undergoing pregnancy and delivery.…”

A functional understanding of moderate to complex congenital heart disease and the impact of pregnancy. Part I: The transposition complexes

“…The epidural space is found with a Tuohy needle, then 1 mL of plain 0.25% bupivacaine with fentanyl 25 lg is injected intrathecally and epidural 10-15 mL boluses of 0.1% bupivacaine with fentanyl 2 lg/mL may be given half-hourly at the request of the patient. [37][38][39] If systemic ventricular function is good, and the woman appears well in labour, then it is sensible to use non-invasive monitoring, blood pressure, electrocardiography and pulse oximetry. If systemic ventricular function deteriorates then intra-arterial continuous blood pressure monitoring is useful.…”