Abstract
Women with structural cardiac or coronary artery disease may have an attenuated ability to adapt to the cardiovascular changes associated with pregnancy. Cardiopulmonary bypass (CPB) involves the use of an extracorporeal circuit in series with the maternal circulation and provides artificial oxygenation, ventilation, and perfusion. The use of CPB may be necessary and unavoidable for many urgent or emergent cardiac surgical repairs. Although fetal mortality is still high, safer and more contemporary medical management of CPB has improved both maternal and fetal outcomes. Due to the systemic inflammatory response and lack of pulsatility with most CPB procedures, off-pump coronary artery bypass grafting may be an alternative during pregnancy. Cesarean delivery during CPB should be avoided because of significant bleeding risk to the mother during heparinization. Priming of the CPB circuit produces hemodilution, which is an important element of CPB. It decreases blood product utilization and its attendant costs and risks.
Original language | English (US) |
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Title of host publication | Critical Care Obstetrics, Seventh Edition |
Publisher | wiley |
Pages | 305-322 |
Number of pages | 18 |
ISBN (Electronic) | 9781119820260 |
ISBN (Print) | 9781119820246 |
DOIs | |
State | Published - Jan 1 2024 |
Keywords
- cardiopulmonary bypass
- cesarean section
- coronary artery bypass grafting
- fetal mortality
- maternal effects
- pregnancy
ASJC Scopus subject areas
- General Medicine